ObjectiveThis study examined the prevalence and predictors of obstructive sleep apnea (OSA) risk in patients with chronic schizophrenia.MethodsA cross-sectional survey was conducted with 441 institutionalized patients with schizophrenia at hospital. Participants completed the Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and STOP-Bang Questionnaire (SBQ) assessing risk of OSA. Logistic regression analysis was used to identify factors associated with OSA risk (SBQ score ≥3).ResultsOSA risk was identified in 236 participants (53.5%). Each 1-cm increase in waistline was associated with an 8% increased risk of OSA (OR = 1.08), and each 1-point increase in insomnia severity score was associated with a 9% increased risk (OR = 1.09).ConclusionsOver half of patients with chronic schizophrenia were at elevated risk for OSA, with insomnia severity and central obesity as the main correlates. Early screening, ongoing monitoring, and collaboration with mental health professional staff are essential for timely intervention, tailored care, and health promotion.

ObjectiveHead injury often causes depression, yet risk factors remain poorly understood. Muscle mass, linked to metabolic and neuroendocrine functions, may influence depression among adults with prior head injury and loss of consciousness (DPHI-LOC), but evidence is lacking.MethodsA cross-sectional analysis was conducted using data from the 2011-2014 National Health and Nutrition Examination Survey. The Appendicular Skeletal Muscle Mass Index (ASMI) was used to quantify muscle mass, and depressive symptoms were measured by the 9-item Patient Health Questionnaire (PHQ-9). Weighted multivariate logistic regression and propensity score matching (PSM) were used to evaluate associations between low muscle mass and DPHI-LOC, adjusting for demographic, socioeconomic, and clinical confounders. Subgroup analyses and interaction tests examined effect modifications across strata.ResultsAmong 2361 adults with head injuries, 232 (8.8%) were reported with DPHI-LOC. Low ASMI was independently associated with an elevated DPHI-LOC risk (adjusted OR = 2.35, 95% CI = 1.24∼4.46, = 0.020). PSM analysis confirmed a 2.82-fold increased likelihood of depression in participants with low muscle mass (95% CI: 1.54∼4.09, = 0.007). Subgroup analyses demonstrated that there were no significant effect modifications.ConclusionReduced muscle mass is a significant correlate of DPHI-LOC. These findings suggest that preservation of muscle mass may help to mitigate risk of depression after head injury.

ObjectiveAdvances in cardiac surgery and medicine have resulted in congenital heart disease (CHD) not being limited to children. CHD has been linked to emotional disorders, and untreated psychiatric disorders can worsen adult CHD patients' morbidity and mortality. This study sought to deepen the understanding of depression and anxiety in this population.MethodA cross-sectional study involving 378 adult outpatients with CHD aged 18 years or older was conducted. Cluster sampling was performed at cardiac center clinics in Riyadh, Saudi Arabia, and data were collected through questionnaires that included demographic information, the Generalized Anxiety Disorder Scale (GAD-7), and the Patient Health Questionnaire (PHQ-9), both of the latter validated in Arabic. Clinical characteristics were assessed using physician-rated New York Heart Association (NYHA) functional class for CHD.ResultsDemographic findings revealed a diverse population with the majority aged 18-24 (56.9%), 52.6% women, and 97.1% Saudi nationals. The clinical characteristics of CHD patients indicated that 63.2% were classified as NYHA Class I and 54.0% had simple CHD. A total of 14.6% of participants reported moderate or severe anxiety and 18.3% indicated moderate or severe depression. Significant associations were found between demographic factors and PHQ-9 and GAD-7 scores. Higher PHQ-9 scores were associated with age ≥35, female gender, and NYHA Class II-IV. Similar associations were observed for GAD-7 scores.ConclusionsDepression and anxiety symptoms were relatively common in this population, underscoring the need for comprehensive mental health support for adult patients with CHD. The association between negative emotions and certain demographic and clinical factors emphasizes the importance of providing personalized care to these patients.

ObjectiveInternet use had been correlated with depression previously. But the association between dynamic changes in internet use status and depression remains unclear. Therefore, the objective of this study was to explore whether changes in internet use status could affect the risk of depression.MethodAll the data were from China Health and Retirement Longitudinal Study (CHARLS). We selected wave 3 (2015) and wave 4 (2018) as the baseline and dynamic changes analyses, respectively. 11 335 participants were included. Internet use was assessed by questionnaire, and depression was assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). Multivariable logistic regression models were employed to assess the association of internet use status and its dynamic changes with risk of depression.ResultAfter adjusting for potential confounders, baseline internet use was negatively associated with risk of developing depression. After 2-year follow-up, compared with those who didn't use the internet in either 2015 or 2018 (non-users), people who ever used (OR = 0.81, 95% CI = 0.58-0.98) or continuously used the internet (OR = 0.64, 95% CI = 0.51-0.82) demonstrated a lower risk of incident depression. Moreover, the risk of the depression significantly declined when the offline individuals commenced using the internet (OR = 0.66, 95% CI = 0.55-0.79).ConclusionInternet use and initiation of Internet use were associated with reduced risk of developing depression in middle aged and older Chinese adults.

ObjectiveHuman flourishing (HF) has received increasing attention in the academic literature as a common goal towards which all strive. Many individuals are involved in a religious community or practice other forms of religious involvement, which they believe leads to a flourishing life. This general review examines the research exploring the association between religious involvement and HF.MethodsThe review examines the quantitative research published in peer-reviewed medical, nursing, psychiatric, public health, and social science journals that examines the connection between religious involvement and six widely acknowledged dimensions of HF and the four pathways that lead to it. The emphasis here is on previously conducted systematic reviews of the literature, while also providing more recent studies to support the findings from these earlier reviews.ResultsThere is a growing amount of research showing that religious involvement is related to various aspects of human flourishing and the pathways that lead to it. However, there are a number of studies that do not report these positive findings. Hypothetical mechanisms, limitations of this review, clinical implications, and future research needs are also provided.ConclusionsPrimary care physicians and mental health professionals may benefit from knowing about the research on this topic as they care for patients, many of whom are spiritual or religious.

ObjectiveIron deficiency anemia is one of the most common nutritional disorders in the world, particularly among women and children. This condition, caused by insufficient iron levels in the body, not only affects physical performance and reduces energy but can also have a significant impact on mental health. This study compared the general health and mental health of individuals with iron deficiency anemia with that of healthy individuals.MethodHealthy individuals and those with iron deficiency anemia were assessed at the Aramesh Pathobiology and Genetics Laboratory in Tehran, Iran. Participants were a convenience sample of 170 healthy individuals and 170 individuals with iron deficiency anemia. Data were collected using the General Health Questionnaire and the Irritability Questionnaire.ResultsIndividuals with iron deficiency anemia scored higher than healthy individuals on somatic symptoms, anxiety and insomnia, social dysfunction, and depression. Irritability was also significantly higher in this group, indicating a possible negative impact of iron deficiency anemia on emotional regulation. Furthermore, irritability and social dysfunction strongly predicted iron deficiency anemia.ConclusionIron deficiency anemia increases the risk of symptoms of mental disorder, including depression, anxiety, irritability, insomnia, social dysfunction, as well as symptoms of physical health problems.

ObjectiveThis study explored health professionals' experiences of using Artificial Intelligence (AI) in healthcare with a particular focus on the potential benefits and challenges of using AI in clinical practice.MethodUsing a qualitative research design, data were collected through in-depth interviews with twenty-two health professionals from various medical specialties in north Punjab, Pakistan using purposive sampling technique. Thematic analysis identified recurring themes on AI adoption.ResultsHealth professionals recognized AI as a psychosocial modifier which increased efficiency and overall professional well-being. Participants expressed that AI should function as a supportive tool rather than a replacement for human judgment, empathy, and patient interaction. However, they also acknowledged a hesitation to incorporate AI due to a distrust of its accuracy and that institutions have been slow to adopt AI due to ethical, technical, and institutional challenges".ConclusionAI adoption is increasingly reshaping clinical practice, but sustainable integration requires balancing innovation with ethical safeguards, trust and empathy.

ObjectiveGeneralized anxiety disorder (GAD) is a condition that can cause persistent and excessive worry, leading to physical and emotional symptoms. Acupuncture, a traditional Chinese medicine practice, has been studied as a potential treatment for anxiety disorders, including GAD. Though acupuncture at HT-7 and GV-20 along with other acupuncture points reduce anxiety level, no study to our knowledge has examined the effect of acupuncture at HT-7 and GV-20 alone in GAD. Therefore, the purpose of this study was to examine the effect of needling at HT-7 (Shenmen) and GV-20 (Baihui) acupuncture points on anxiety levels and cardiovascular function in patients with GAD.MethodsA total of 60 participants ages 20-55 diagnosed with GAD were randomly assigned to either a study group or a control group. The study group received acupuncture at the HT-7 and GV-20 points, while the control group underwent breath awareness meditation in supine position. Both groups underwent 20 min of the practice daily for 10 days. Assessments such as Hamilton Anxiety Rating Scale (HAM-A) score, blood pressure (BP) and pulse rate (PR) were performed before and after the intervention.ResultsParticipants in the study group had a significant reduction in anxiety levels ( < .001) compared to the control group. No significant inter-group differences were observed in systolic BP ( = .686), diastolic BP ( = .998), or PR ( = .925).ConclusionThe present study suggests that needling at HT-7 and GV-20 acupuncture points (20 min/session for 10 days) reduces anxiety levels without affecting cardiovascular function in younger and middle-aged patients with GAD.

ObjectiveWith the rapid adoption of artificial intelligence (AI) technologies by adolescents, the impact on their mental health is of critical concern. This article examines the emerging phenomenon of AI-related psychosis, which can be defined as new-onset or exacerbated psychotic experiences with generative AI platforms, such as chatbots, avatars, and virtual agents like Siri and Alexa.MethodNarrative review and perspective.ResultsAdolescents are particularly susceptible due to ongoing neurodevelopmental immaturity, including underdeveloped prefrontal regulatory circuits and heightened limbic system reactivity, which may impair emotional regulation and reality testing. Combined with extensive digital engagement, these factors increase vulnerability to psychotic experiences in response to AI interactions. This article examines behavioral risk factors, online habits, and neurobiological susceptibilities that may predispose adolescents to such experiences. In addition, implications are outlined for healthcare providers, including an emphasis on proactive screening, digital literacy education, and early intervention strategies. Clinical approaches to recognize and manage AI-related mental health risks in adolescents are also proposed.ConclusionsA multidisciplinary response by clinicians, educators, developers, and policymakers is needed to guide ethical AI design and safeguard the well-being of adolescents in today's digital environment.

ObjectiveThis study sought to determine the frequency and factors influencing Impulsive Control Disorders (ICDs) in prolactinoma patients undergoing treatment with dopamine agonists.MethodsA cross-sectional study involving a convenience sample of 170 patients diagnosed with prolactinoma and receiving dopamine agonist therapy for at least 6 months. Participants were recruited from a single center.ResultsAt least one self-reported ICD symptom was present in 23.5% of patients. The most prevalent ICD symptoms were binge eating (17.7%), hypersexuality (14.7%), and compulsive shopping (11.8%). Correlates of ICD symptoms were male gender, macroprolactinoma, elevated prolactin levels, and a previous mental disease history. The likelihood of ICDs increased with the cumulative dose of dopamine agonist medication and the length of treatment. Moreover, individuals with moderate to severe anxiety and depression had a greater risk for ICD compared to those without these symptoms.ConclusionsClinicians should prioritize attention during initial diagnosis and ongoing treatment of patients with prolactinoma to risk factors that may elevate the risk of later development of ICDs.

ObjectiveApproximately 295 million individuals globally live with moderate to severe irreversible vision loss, primarily due to conditions such as glaucoma, diabetic retinopathy, and age-related macular degeneration (AMD). Vision impairment diminishes quality of life leading to higher rates of depression and anxiety. This study investigated the prevalence of anxiety and depression in patients with irreversible vision loss, with a comparative analysis across the conditions of AMD, diabetic retinopathy, and glaucoma.MethodsA comprehensive literature search was conducted in Medline, Embase, CINAHL, and Cochrane databases, supplemented by manual searches of conference literature.ResultsThe prevalence of depression in patients with irreversible vision loss was found to be 21% (95% CI: 0.17-0.26) among 76 561 patients, with variations based on the cause: 27% (95% CI: 0.19-0.35) in AMD, 48% (95% CI: 0.32-0.64) in diabetic retinopathy, and 23% (95% CI: 0.16-0.29) in glaucoma. Anxiety prevalence was 22% (95% CI: 0.15-0.30) among 25 616 patients.ConclusionThe high prevalence of depression and anxiety underscores the need for comprehensive healthcare approaches that incorporate mental health support, including vision rehabilitation, psychotherapy, pharmacological interventions, and lifestyle modifications. Future research should explore factors that protect against anxiety and depression, as well as address the long-term effects of vision loss treatments on mental health outcomes.

ObjectiveThis study investigated ADHD comorbidity and clinical features, including hyperfocus, in women with depressive or anxiety disorders, addressing the diagnostic complexities arising from symptom overlap and the underdiagnosis of ADHD in this population.MethodsFemale patients from outpatient psychiatric clinics (n = 170) were assessed using the Beck Depression Inventory and Beck Anxiety Inventory. Participants meeting threshold scores underwent further evaluation with the Wender-Utah Rating Scale, Hyperfocus Scale, and Adult ADHD DSM-IV-Based Diagnostic Screening Scale, complemented by structured clinical interviews.ResultsADHD was identified in 19.6% (n = 33) of patients, 45.5% (n = 15) of whom were previously undiagnosed. ADHD was most prevalent in patients with social anxiety disorder (46.4%) and double depression (40.6%). In non-ADHD participants, attention deficit correlated positively with depression (r = 0.236, p = 0.005), hyperactivity with anxiety (r = 0.187, p = 0.029), and hyperfocus with ADHD scores (r = 0.434, p < 0.001; r = 0.292, p = 0.001); no such correlations were seen in the ADHD group.ConclusionADHD is common and frequently overlooked in women presenting with depression or anxiety. While hyperfocus is a relevant clinical feature, it is not diagnostic alone and correlates with ADHD symptoms in the absence of ADHD. Clinicians should conduct thorough screenings for ADHD and carefully interpret hyperfocus within the broader clinical context to ensure accurate diagnosis and timely, appropriate treatment.

ObjectiveTo present a case of probable autoimmune encephalitis initially misdiagnosed as a primary psychiatric disorder.MethodA case of probable autoimmune encephalitis presenting with catatonia in a young woman 6 months post-partum is described in this article.ResultsThe patient was admitted to an outside hospital, diagnosed with a primary psychiatric condition, and sent to psychiatric inpatient, where she was denied admission due to labile hypertension. After admission to the medical service (and ICU), she responded to a lorazepam challenge, and made a complete recovery within several weeks after combination treatment with IV methylprednisolone, IV immunoglobulin (IVIG), and rituximab.ConclusionAutoimmune encephalitis should be suspected in patients presenting with labile vital signs, family history of autoimmunity, and new psychosis without prior history of psychiatric problems. Other important diagnostic considerations include neuroleptic malignant syndrome, substance-induced psychosis, or catatonia secondary to post-infectious immune-mediated encephalitis. While a first psychotic break should always be considered, the presence of autonomic instability, catatonia, seizures, or dyskinesias in a young woman postpartum should prompt a thorough medical and neurological work-up.

ObjectiveEmerging evidence suggests that serum uric acid (SUA) can modulate depressive symptoms, potentially via mechanisms involving oxidative stress. However, whether the serum uric acid/creatinine ratio (SUA/Cr)-a biomarker reflecting net uric acid production-is linked to depressive symptoms in middle-to-late life populations remains unknown.MethodsLongitudinal and cross-sectional analyses were conducted utilizing nationally representative samples from two countries: the China Health and Retirement Longitudinal Study (CHARLS) for longitudinal assessment and the U.S. National Health and Nutrition Examination Survey (NHANES) for cross-sectional evaluation. Multivariable Cox and logistic regression analyses were employed to examine the relationship between the SUA/Cr and depressive symptoms. Dose-response relationships were modeled using restricted cubic splines (RCS), while sensitivity analyses assessed the stability of results. ResultsFrom CHARLS (N = 4317), multivariable Cox regression revealed an inverse relationship between SUA/Cr and depressive symptoms (P-linearity<0.05), with each 1-unit increase linked to a 3% lower risk (HR = 0.97, 95% CI = 0.94-0.99). Q4 showed reduced risk vs Q1 (HR = 0.87, 95% CI = 0.77-0.97). NHANES analysis of cross-sectional data (N = 18 677) confirmed this inverse association (P- linearity<0.05), with a 6% lower odds of significant depression per 1-unit SUA/Cr increase (OR = 0.94, 95% CI = 0.87-1.03). Q3 and Q4 had significantly lower odds vs Q1 (OR = 0.78, 95% CI = 0.64-0.95, and OR = 0.79, 95% CI = 0.65-0.98, respectively). RCS curves confirmed dose-response relationships in both cohorts. Findings remained consistent in sensitivity analyses.ConclusionDepressive symptoms in middle-to-late adulthood were found to be negatively correlated with SUA/Cr levels in longitudinal and cross-sectional analyses. These findings suggest that SUA/Cr levels may function as a biological indicator to facilitate early detection and proactive intervention for depressive disorders.

ObjectivePost-stroke depression (PSD) is the most frequent psychiatric disorder after stroke, occurring in about 30% of stroke survivors. Little is known about the influence of dietary B-vitamin intake on PSD risk. This analysis examined the relationship between dietary B-vitamin intake and depression among stroke patients.MethodsA total of 1080 patients aged ≥20 years and having suffered a stroke participating in the 2007-2018 National Health and Nutritional Examination Surveys (NHANES) were included in this cross-sectional study. Depressive symptoms were evaluated using the 9-item Patient Health Questionnaire (PHQ-9). The association between dietary B vitamins intake and PSD was examined using multiple logistic regression analysis.ResultsAfter controlling for potential confounders (sex, age, race, BMI, family PIR, education level, marital status, history of disease, hypertension, hypercholesterolemia, diabetes, smoking, alcohol use and energy), significant inverse associations were found between dietary vitamin B1 ( = 0.002) and B6 ( = 0.002) intake and PHQ-9 scores. These association were significantly modified by unhealthy lifestyle factors and inflammation-related indicators.ConclusionsDietary vitamin B1 and B6 intake were inversely associated with PSD risk. The association between vitamin B1 or B6 and PSD was modified by unhealthy lifestyle factors and inflammation-related indicators. Future prospective studies are needed to determine the causal relationship between higher dietary vitamin B1 and B6 intake and a lower risk of PSD.

ObjectiveTo examine the effects of metabolic and bariatric surgery on physical outcomes, mental health, and quality of life (QOL) among obese patients in China.MethodsIncluded were 182 patients who underwent laparoscopic sleeve gastroplasty (LSG, a form of metabolic and bariatric surgery). Effects on postoperative weight, waist circumference, hip circumference, BMI, and the percentage of excess weight loss (%EWL) were observed during the 12 months after surgery. Changes in physical comorbidities were also determined. Anxiety symptoms were assessed by the Self-rated Anxiety Scale (SAS); depressive symptoms by the Self-rated Depression Scale (SDS); and QOL by the SF-36 scale. Assessment points were at baseline and 3, 6, and 12 months after surgery.ResultsSignificant improvements were observed in weight, waist circumference, hip circumference, BMI, and %EWL after surgery ( < 0.05). The remission rates for hypertension, diabetes, fatty liver, hyperlipidemia, and obstructive sleep apnea-hypopnea syndrome (OSAHS) were 89.5%, 95.5%, 82.6%, 81.7%, and 61.7%, respectively, 1 year after surgery ( < 0.05). Anxiety (SAS) and depressive (SDS) symptoms decreased significantly over time ( < 0.05). SF-36 scores in the physical and psychological domains increased significantly ( < 0.05). However, overall SF-36 scores were higher at 6 months compared to 12 months ( < 0.05).ConclusionLaparoscopic sleeve gastroplasty results in significant weight loss in the short term, which can improve anxiety symptoms, depressive symptoms, and QOL in obese patients. However, some social and psychological improvements appear to plateau at 6 months following surgery.

ObjectiveTo compare the antidepressant efficacy, cognitive impact, and safety profile of magnetic seizure therapy (MST) vs modified electroconvulsive therapy (MECT) in Chinese adolescents with treatment-resistant major depressive disorder (MDD).MethodsThis single-center, evaluator-blinded, prospective randomized controlled trial enrolled 120 adolescents aged 13-18 years diagnosed with treatment-resistant MDD. Participants were randomly assigned to either the MST group or the MECT group (n = 60 per group). The primary outcome was improvement in depressive symptoms measured by the Beck Depression Inventory-II (BDI-II) score reduction rate. Secondary outcomes included changes in cognitive function assessed by the Montreal Cognitive Assessment (MoCA), time to reorientation, and adverse event incidence per CTCAE 5.0 criteria.ResultsThe BDI-II reduction rate was significantly higher in the MECT group (51.8%) compared to the MST group (46.5%) ( < 0.001), though clinical response rates were similar (90.0% vs 91.1%). The MST group showed significant improvement in MoCA total score, whereas the MECT group demonstrated slight declines ( < 0.001). MST was associated with greater cognitive preservation (+0.96 vs -0.36 MoCA score), fewer adverse events (28.9% vs 64.0%, < 0.001), and faster reorientation (6.9 ± 1.8 min vs 18.7 ± 6.8 min, < 0.001).ConclusionMST exhibited comparable antidepressant efficacy to MECT while offering superior cognitive protection and safety in adolescents with treatment-resistant MDD. These findings suggest MST may be a preferred treatment option balancing symptom relief with neurodevelopmental preservation.

ObjectiveThis qualitative study examined the psychosocial support needs of small cell lung cancer (SCLC) patients within China's family-oriented cultural context. Guided by cultural adaptation theory, the study explored how cultural values shape patients' psychological experiences and treatment decision-making.MethodsUsing a phenomenological purposive sampling strategy, 32 SCLC patients from a tertiary oncology hospital in Tianjin, China (May 2024-March 2025) participated in semi-structured, in-depth interviews. Transcripts were managed with NVivo 12, and themes were identified using Colaizzi's phenomenological analysis.ResultsDistinct cultural factors influenced patient needs. Six major themes emerged: (1) dual psychological crises stemming from disease stigma and prognostic dread; (2) pervasive insecurity due to recurrence uncertainty; (3) heightened decision-making stress and information asymmetry; (4) Ethical and Familial Complexities in Treatment Choices-patients struggled to balance personal survival with family responsibilities and financial constraints; (5) an imbalance between the desire for professional psychological support and reliance on informal peer networks; and (6) deliberate suppression of negative emotions to maintain family stability.ConclusionsThe findings revealed a conflict between medical imperatives and entrenched family-oriented cultural values, underscoring the complexity of providing psychosocial support in SCLC care to Chinese patients.

ObjectiveFew studies have simultaneously addressed self-management of cardiovascular and mental health in Black women at cardiovascular risk. This 24-week pilot prospective crossover randomized-controlled trial tested TEAM-Red, a 5-session, biweekly, nurse and peer-educator remotely delivered group self-management intervention for young Black women, vs Enhanced waitlist control (eWL).MethodsTEAM-Red intervention, adapted from an evidence-based program and culturally tailored based on stakeholder input, enrolled 50 depressed Black women ages 18-49 with at least one risk factor for hypertension. Participants were randomized to TEAM-Red (n = 25) or eWL (n = 24) and assessed at Screening, Baseline, 12 weeks, and 24 weeks. Those in eWL crossed over to receive TEAM-Red at 12 weeks and all participants were followed to 24 weeks. The primary goal was acceptability and feasibility. The primary outcome was change on depression severity from baseline to 12 weeks assessed via 9-item Patient Health Questionnaire (PHQ-9). Secondary outcomes were perceived stress, mental health quality of life, diet quality, energy expended, social support, hypertension knowledge, and alcohol use.ResultsAmong women depressed at baseline (N = 31), TEAM-Red participants had 17.1 times higher odds of depression remission at week 12 (OR = 17.14, 95% CI: 1.78, 164.97; = .014). At 12 weeks, TEAM-Red participants showed significantly lower PHQ-9 scores ( = .042), improved diet quality ( = .025) and mental health quality of life ( = .032) and reduced perceived stress ( = .038) compared to eWL. Treatment satisfaction and engagement was high (89% found it useful), with 22% attrition.ConclusionsTEAM-Red demonstrated significant clinical benefits with a 17-fold higher odds of depression remission and meaningful improvements in mental health quality of life, diet quality, and perceived stress compared to controls. Despite limitations including small sample size and short follow-up period, this culturally tailored intervention shows promise for reducing cardiovascular risk and improving mental health outcomes in young Black women at risk for hypertension should results be replicated with a larger sample in a fully powered trial.

ObjectiveSuicide reattempts, reflecting ongoing vulnerability, are common among individuals with prior attempts, yet data from Iran is limited. This study explored reattempts among all suicide attempters who survived in the Fars province during the year 2023 to inform prevention strategies.MethodsThis prospective study analyzed all registered suicide attempts and death in the Fars during 2023, using a comprehensive database, the Integrated Suicide Data Monitoring and Registration System. Cases were determined and reviewed over 352 days to identify reattempts. Variables included demographic data, attempt history, and occasion-related factors. Statistical analyses involved descriptive statistics, chi-square, -tests, and logistic regression to examine factors predicting suicide reattempts using SPSS, with significance set at < .05. Ethical approval was secured from the relevant committee.ResultsAmong all cases, 577 individuals (6.1%) reattempted suicide out of a total of 9472 attempters (failed or succeeded). Gender distribution among re-attempters was similar. Single individuals had higher reattempt rates. Although re-attempters had a lower fatality rate than first-time attempters, the difference was not statistically significant. The average interval between attempts was 5.2 weeks, and 75% occurred within 15 weeks. Logistic regression revealed that being single significantly increased reattempt odds (OR = 1.57, 95% CI: 1.17-2.11, = .003), while other factors such as age, gender, and day of the week were not significant.ConclusionOur findings indicated that single individuals were more vulnerable to suicide reattempts, underscoring the need for targeted and timely interventions. Being alert in the high-risk post-attempt period is crucial. Future studies should use longitudinal and qualitative methods to explore the complex interplay of personal, social, and systemic factors predicting suicide reattempt.

ObjectiveIndia faces a critical shortage of mental health professionals, leaving primary care physicians (PCPs) as the primary point of contact for many individuals needing psychiatric care. The Diploma in Primary Care Psychiatry Program (DPCP), a one-year training initiative, aims to equip PCPs in India to manage psychiatric conditions in underserved areas. On-Consultation Training (OCT) is a module in the DPCP designed exclusively for practicing PCPs where a psychiatrist trains PCPs in live video streaming of their own real-time general consultations of primary health centres. This study identifies a training gap within the DPCP.MethodsPCPs (n = 62) from Uttarakhand, Bihar, and Karnataka states in India received training in the DPCP from 2019 to 2024. Assessed were their exposure to six psychiatric disorders (tobacco addiction, alcohol addiction, psychosis, somatization disorder, anxiety disorder, and depressive disorder) during On-Consultation Training (OCT) sessions. Adequate training per doctor was defined as encountering at least two patients with each disorder.ResultsA total of 650 psychiatric cases seen during OCT sessions were reviewed. Only tobacco addiction and depressive disorder met the training adequacy benchmark (exposure to two cases with the disorder). Alcohol addiction, psychosis, somatization disorder, and anxiety disorders fell below the threshold, highlighting a specific training gap.ConclusionsThis study identified a training gap in the DPCP. The restructuring of the Collaborative Video Consultation (CVC) module with case-specific quotas, expert case demonstrations, and enhanced real-time feedback during OCT could help close this and other training gaps. Addressing these issues will better prepare PCPs in India to manage a broader range of psychiatric conditions, enhancing mental health care delivery in primary care settings.

ObjectiveThe syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a potentially life-threatening electrolyte disturbance commonly encountered in older adults, particularly in association with serotonergic and dopaminergic medications. Both duloxetine and levodopa have been individually implicated in the development of SIADH, although the mechanism often remains unclear.MethodsSingle case presentation and review.ResultsA 73-year-old woman with newly diagnosed depression and parkinsonism was initiated on duloxetine (30 mg/day) and levodopa/benserazide (tradename Madopar) (100/25 mg, 3 times daily). Within 24 h, she developed fatigue, nausea, confusion, and dizziness. Laboratory evaluation revealed severe hyponatremia (serum sodium: 115 mmol/L), low serum osmolality (230 mOsm/kg), high urine osmolality (310 mOsm/kg), and urinary sodium of 43 mmol/L, with a clinically euvolemic status. Thyroid and adrenal function test were normal. Both medications were discontinued. Fluid restriction and hypertonic saline infusion led to normalization of sodium levels over 72 h, with complete clinical recovery.ConclusionThis case highlights an unusually rapid onset of SIADH after combined initiation of duloxetine and levodopa/benserazide. The temporal proximity of symptom onset suggests a possible synergistic interaction. Clinicians should maintain vigilance for acute hyponatremia in older adults shortly after introducing serotonergic and dopaminergic agents.

The age of childbirth for women has been significantly delayed in recent times, leading to an increase in the proportion of pregnant women in advanced maternal age (AMA). Due to increased physiological challenges and higher incidence of pregnancy complications, advanced maternal age women often face greater mental stress, including familial and societal pressures associated with latter-age childbirth. In order to investigate the psychological health of AMA pregnant women during the later stages of pregnancy and peripartum period and identify psychosocial predictors of mental health, we conducted a cross-sectional study on this issue. Selected primiparous women were assessed at three time points (at the 8th month prenatal examination, the day of delivery and 42 days postpartum). There were 125 eligible pregnant women for enrollment at each time points. Sociodemographic characteristics, psychological concerns, and mental health were measured at these timepoints. The incidence of psychological distress among older peripartum women was significantly higher than among younger women. Increased psychological stress was correlated with concerns about maternal and infant health, fear of labor pain, apprehension regarding personal career development, and worries about family support and financial conditions. The mental health status of older peripartum women is concerning, suggesting the need for psychological support by primary care physicians and other healthcare providers.

ObjectiveThis study examined the correlation between psychological status and major adverse cardiovascular events (MACE) in acute myocardial infarction (AMI) patients after percutaneous coronary intervention (PCI). Based on these results, health management strategies were discussed.MethodsA retrospective analysis was conducted in 200 AMI patients who underwent PCI between January 2020 and December 2023 at a tertiary care hospital in China. The incidence of MACE was calculated, and the correlation between Hospital Anxiety and Depression Scale (HADS) scores and MACE was determined.ResultsThree-quarters (75.0%) of patients scored above the threshold on significant anxiety (HADS-A >9) and 61.0% did so for depressive symptoms (HADS-D >9) post-PCI. Multivariate analysis identified higher education (OR: 1.754, 95% CI: 1.080∼2.851), lower income (OR: 0.229, 95% CI: 0.089∼0.589), and smoking (OR: 0.384, 95% CI: 0.159∼0.931) as independent risk factors for anxiety, while low income (OR: 0.236, 95% CI: 0.105∼0.529), smoking (OR: 5.125, 95% CI: 2.213∼11.867), and female gender (OR: 3.042, 95% CI: 0.260∼7.348) were significantly associated with depression ( < 0.05). MACE occurred in 21.5% of patients. First-time PCI (OR: 0.03, 95% CI: 0.003∼0.296) and depression scores were significantly associated with increased MACE risk (r = 0.207, OR: 47.79, 95% CI: 8.38∼272.47, < 0.05), whereas anxiety scores showed no significant association ( > 0.05).ConclusionAnxiety and depression are common post-PCI symptoms in AMI patients, and depressive symptoms are significantly correlated with disease progression (MACE scores). Greater focus on patients' mental health, may help improve the prognosis of AMI patients after PCI.

ObjectiveOvarian cancer patients are more likely to have mental disorders than other patients. However, to our knowledge, there has been no systematic analysis of its global epidemiology. Therefore, a systematic review was conducted to identify the prevalence of depression, anxiety, and suicidal ideation in ovarian cancer patients in different countries.MethodWe searched PubMed, Embase, Elsevier ScienceDirect, China National Knowledge Infrastructure, WanFang Data Knowledge Service Platform, and Duxiu Academic Search Platform to identify observational studies on depression, anxiety, and suicidal ideation in patients with ovarian cancer published up to 30 June 2024. We estimated the prevalence of depression, anxiety, and suicidal ideation in ovarian cancer patients worldwide and by region, country, research period, and assessment scales.ResultsA total of 31 studies were identified involving 8315 ovarian cancer patients. The prevalence rates of depression and anxiety were 35% and 37%, respectively. In China, the prevalence of suicidal ideation of ovarian cancer patients was 32%. Ovarian cancer patients in Asia had the highest prevalence of depression, while those in Oceania (Australia, New Zealand, etc.) had the lowest. Additionally, the prevalence rates of depression and anxiety increased considerably worldwide after 2000 and have gradually stabilized since then.ConclusionThis study found that the prevalence of depression and anxiety was high (more than one-third) among ovarian cancer patients. These findings underscore the need for a comprehensive study to address mental health problems in these patients, including the determination of incidence rates, investigation of regional differences, and assessment of comorbidities and treatment strategies.

ObjectiveThis study assessed the 24-h nutrient intake, adequacy of intake, and associated factors among outpatients diagnosed with major depressive disorder (MDD) in Ho Chi Minh City, Vietnam.MethodA cross-sectional study was conducted among 290 adult outpatients diagnosed with MDD at University Medical Center, Ho Chi Minh City, Vietnam. Participants completed a 24-h dietary recall and the Quick Inventory of Depressive Symptomatology (QIDS-SR). Nutrient intake was analyzed using Vietnamese food composition tables and categorized based on national dietary recommendations. Mean daily nutrient intakes were calculated for energy, macronutrients, and micronutrients. Multivariate analyses assessed associations between demographic, clinical, and psychosocial factors and nutrient intake.ResultsParticipants demonstrated low average intake of energy, macronutrients, and essential micronutrients. A majority had inadequate intake of total energy, carbohydrates, fats, and key vitamins and minerals such as calcium, potassium, and vitamins A and C. Nutritional deficiencies were more pronounced among individuals with greater depression severity, limited time for self-care, underweight status, and fewer economic resources. Principal component analysis revealed two main dietary patterns: one nutrient-rich and another characterized by high fat and sodium with low vitamin content.ConclusionsIndividuals with MDD in Vietnam demonstrate widespread inadequacy of nutrient intake, which was associated with both depression severity and several sociodemographic factors. These findings underscore the importance of integrating nutrition assessment and intervention into mental health care in the country of Vietnam and likely elsewhere.