Agoraphobic avoidance, fear of situations that seem hard to escape, is common across mental disorders and often remains untreated due to stigma and limited service access. Automated virtual reality (VR) exposure therapy offers a scalable alternative by enabling safe, guided simulations of feared situations. This randomized controlled trial evaluated the efficacy of a culturally adapted version of gameChange VR for reducing agoraphobic avoidance among adults in Hong Kong without psychiatric diagnoses.

Posttraumatic stress disorder (PTSD) presents a significant challenge within the treatment of mental health issues, particularly in veterans and first responders who often experience resistance to standard treatments. This study evaluated the effectiveness of a virtual reality exposure-based treatment with motion as compared to treatment as usual (TAU), as first-line treatment for PTSD within these populations.

Psychotropic medications are frequently prescribed alongside trauma-focused psychotherapy for post-traumatic stress disorder (PTSD), yet their impact on treatment response remains uncertain. This study emulated target trials to examine the association between psychotropic co-medication at treatment onset and psychotherapy outcomes in a real-world PTSD cohort.

Verbal instructions modulate the expectation concerning a given drug. Knowing that the prescribing clinician is positive and enthusiastic toward the prescribed treatment may lead to positive expectations. We tested whether administering strongly positive verbal instructions together with a pharmacological prescription might trigger a placebo effect in migraine patients.

Mechanisms of change are widely assumed to be activated by the onset of treatment. This foundational premise underlies decades of psychotherapy research and guides the timing of measurement and intervention in clinical science. The present study challenges this assumption by demonstrating that one of the most well-established predictors of treatment outcome-the therapeutic alliance-not only changes before therapy begins, but that these early, pre-treatment changes predict both alliance development and symptom reduction throughout treatment. In a randomized controlled trial for depression (N=100), the therapeutic alliance was assessed twice before patients met their therapist, and weekly thereafter. The pre-treatment change in alliance significantly predicted subsequent alliance dynamics and clinical improvement, above and beyond baseline levels. The findings remained robust even after controlling for pre-treatment outcome expectations and previous treatment experience. These findings suggest that mechanisms traditionally viewed as the result of treatment targeting may, in fact, be antecedents. By revealing pre-treatment shifts in a mechanism once thought to be non-existent prior to patient-therapist contact, this work may challenge fundamental assumptions in clinical psychology and highlights the need to reconceptualize therapeutic change as a dynamic, temporally extended process that may begin before any intervention has occurred. Such a shift has implications for how we define, measure, and intervene on core mechanisms of human change.

Access to effective post-traumatic stress disorder (PTSD) treatment is limited in low-resource regions (LRRs).

Achieving sustainable success in the treatment of anxiety disorders remains a central objective in mental health care. Although research has demonstrated the short-term efficacy of psychotherapy, evidence regarding long-term sustainability is limited. This study examined treatment outcomes five years after prediction-error-based exposure therapy.

Patients with Major depressive disorder (MDD) and Borderline personality disorder (BPD) show a poorer prognosis compared to patients without BPD. A potential contributor is the complexity of establishing a therapeutic alliance with patients with BPD. A potential underlying biological mechanism is Oxytocin (OT), a hormone associated with social bonding and trust. The aim of this study was to assess whether the interaction between OT pre-session (session-level trait-like) and change in OT throughout session (state-like) in both patients and therapists predicts the therapeutic alliance in patients with MDD and varying severity of BPD. We hypothesized that patients with higher BPD severity would show a compensatory pattern, where increase in state-like OT would compensate for low session-level trait-like OT, resulting in a stronger alliance. We also explored this interplay in the therapists' OT.

Adolescents in many low- and middle-income countries are frequently exposed to adversities such as armed conflicts and economic hardship. These stressors occur during a critical developmental period marked by profound physical, social, and psychological changes, increasing vulnerability to mental disorders. To address this mental health care need, the World Health Organization (WHO) and UNICEF developed Early Adolescent Skills for Emotions (EASE), a 10-session group intervention for adolescents and their caregivers. This systematic review summarizes current evidence regarding the effectiveness and implementation of EASE.

Obsessive-compulsive disorder (OCD) is a chronic condition where many patients remain symptomatic despite first-line treatments such as cognitive behavioural therapy and selective serotonin reuptake inhibitors. This randomised controlled trial evaluated mindfulness-based cognitive therapy (MBCT) efficacy as an augmentation strategy and its impact on brain functional connectivity.

Borderline personality disorder (BPD) is a complex and heterogeneous condition. Psychotherapy reduces symptom severity; however, characteristics of the individual may influence treatment outcomes. This systematic review examined whether specific baseline variables moderate the effect of psychotherapy on BPD severity through individual participant data meta-analysis (IPD-MA).

Depression is a common mental disorder with often persistent consequences. Even after adequate treatment, recovery may be far from optimal. To enhance outcomes, we aimed to identify and synthesize factors that depressed adults themselves perceived as facilitating or hindering recovery.

Visceral adipose tissue (VAT) is a metabolically active fat depot linked to cardiometabolic disease, but its relationship with depression independent of general and central adiposity remains unclear. We investigated the association of MRI-quantified VAT with the incidence of depression and evaluated whether it predicts depression risk beyond the body mass index (BMI) and the waist-to-height ratio (WHtR).

Mindfulness has been shown to benefit children and adolescents. However, predictors of treatment effects of mindfulness-based interventions (MBIs) are less well known. The purpose of the study was to test the treatment effect of MBIs in children/adolescents, test for moderation by meditation practice history (MPH) of the investigator(s), and compare moderation by MPH to other study- and participant-level variables.

Most previous mortality research in eating disorders (EDs) involves individuals attending specialist treatment services. Data linkage across jurisdictional health databases at a population level improves the generalisability of findings. This study investigates mortality risk and causes of death for people with an ED across a large geographic region using administrative health datasets.

Understanding chronic stress as a potential risk factor for COVID-19 progression could inform public health measures and personalized preventive interventions. Therefore, we investigated the influence of chronic stress prior to SARS-CoV-2 infection on symptom persistence 1 month after COVID-19 onset.

Treatment resistance in anxiety disorders (TR-ADs) constitutes a major clinical challenge conferring a considerable burden regarding quality of life and societal health costs.

Self-injurious thoughts and behaviors (SITBs) are major public health issues worldwide. In recent years, there has been a growing body of research investigating the application of acceptance and commitment therapy (ACT) for SITBs. This study systematically reviews and meta-analyzes the effectiveness of ACT in reducing SITBs.

Mental pain - a pain not primarily felt in the body - is a predictor of suicide and is often described as one of the most distressing aspects of depression. However, the absence of a clear definition hampers both research and clinical practice. This metasynthesis aims to characterize the lived experience of mental pain to inform the future development of a definition.

Fear of cancer recurrence (FCR) is a prominent clinical issue among cancer survivors. This study evaluated the effectiveness of the culturally adapted ConquerFear-HK intervention in reducing FCR among Chinese cancer survivors, compared to standard survivorship care.

Major depressive disorder (MDD) is currently the second leading cause of life expectancy due to disability globally. This study aimed to examine the disease burden, risk factors, and temporal trends of MDD in low- and middle-income countries (LMICs) from 1990 to 2021.

Exposure to trauma has been theorized to contribute to the onset and exacerbation of obsessive-compulsive disorder (OCD), yet direct empirical evidence remains limited. This study examined whether individuals directly affected by the trauma of October 7th, 2023, in Israel exhibited higher rates of new-onset or worsening OCD symptoms compared to controls who were not directly affected.

Psychotherapy is the primary treatment for adolescent borderline personality pathology (BPP), yet its mechanisms remain unclear. Given potential self-report biases due to alexithymia and impaired interoception, this study examined cortisol responses as a physiological stress marker alongside session ratings from adolescent BPP patients and their therapists to assess its potential as a complementary measure in psychotherapy process research.

Children exposed to adverse experiences are more likely to experience mental health problems in adulthood. However, adverse childhood experience (ACE) assessment is highly heterogeneous, hampering widespread screening and trauma-informed care provision. We aimed to systematically identify and critically evaluate all-validated, self-report ACE questionnaires, working with people with lived experience (PWLE).

Somatic diseases comorbid with depression exacerbate the health burden. The interoceptive neural circuit (INC) might mediate brain-body connections. We aimed to assess the causal relationship between somatic diseases, the INC, and depression.

Individuals with a personality disorder (PD) often report high exposure to adverse events. Given the strong link between negative life events and PD pathology, it is essential to evaluate trauma-focused treatments in this population. This study evaluated the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy versus waitlist in reducing post-traumatic stress disorder (PTSD) symptoms and diagnostic status, distinguishing between patients with and without PTSD. Second, it examined the impact of EMDR therapy on adverse event memories, both meeting and not meeting Criterion A for PTSD.