Fine particulate matter (PM2.5) exposure and unfavourable lifestyle are both significant risk factors for mental health disorders, yet their combined effects on adolescent depression and anxiety remain poorly understood. This study aims to determine whether PM2.5 exposure and lifestyle are independently associated with adolescent depression and anxiety, and whether there are joint effects between these factors on mental health outcomes.

In this cross-sectional study, 19852 participants were analysed. PM2.5 concentrations were obtained from the ChinaHighAirPollutants (CHAP) dataset. Lifestyle factors were assessed through self-reported questionnaires, and a healthy lifestyle score was developed based on eight lifestyle risk factors. Depression and anxiety were assessed using the PHQ-9 and GAD-7 scales. Restricted cubic spline analysed dose–response relationships between PM2.5 exposure and mental health outcomes. The independent and joint effects were assessed using logistic regression models. Both multiplicative and additive interactions (relative excess risk due to interaction, RERI) were examined. Multiple classification approaches were incorporated to ensure robust results.

The study included 19852 participants with a mean age of 15.16 years (SD 1.60), comprising 9886 (49.8%) males and 9966 (50.2%) females. Depression and anxiety were identified in 3845 (19.37%) and 3230 (16.27%) participants, respectively. PM2.5 exposure showed a linear dose-response relationship with depression and anxiety. Joint effects analysis at the 75th percentile of PM2.5 with a lifestyle risk score of 4 revealed the strongest associations, with adjusted odds ratios of 4.49 (95% CI: 3.79–5.33) for depression, 4.01 (95% CI: 3.36–4.78) for anxiety and 4.24 (95% CI: 3.52–5.10) for their comorbidity. Simultaneously, significant additive interactions (RERI > 0) between high levels of PM2.5 exposure and unfavourable lifestyle factors were detected, suggesting synergistic effects on mental health outcomes. Subgroup and sensitivity analyses confirmed the robustness of these findings.

High PM2.5 exposure and unfavourable lifestyle factors demonstrated significant independent and joint effects on depression and anxiety among adolescents. These findings highlight that implementing stringent air pollution control measures, combined with promoting healthy lifestyle practices, may be crucial for protecting adolescent mental health.

Previous studies have indicated that depression is common among young adults. However, these studies have mainly focused on risk factors rather than protective factors, especially in the context of Vietnam.

To explore protective factors such as self-compassion and the mediating role of gratitude, crucial for informing targeted interventions aimed at reducing depression in this population.

A cross-sectional study was conducted in September 2023 using convenience sampling of individuals aged 18–25 years (n = 356, mean age 21.23 years) living in Ho Chi Minh City, Vietnam, recruited via online surveys distributed through social networks. The required sample size was determined using Monte Carlo power analysis to ensure adequate statistical power for mediation analysis. Data were analysed to examine the mediating role of gratitude (Gratitude Questionnaire – Six Item Form, GQ-6) in the relationship between self-compassion (Self-Compassion Scale – Short Form, VSCS-SF) and depression (Patient Health Questionnaire-9, PHQ-9).

Self-compassion showed a significant negative association with depression (β = −0.50, t = −11.42, p < 0.001), accounting for 27% of the variance in depression scores. Gratitude significantly mediated this relationship, with an indirect effect of a × b = −0.07 (s.e. = 0.02, 95% CI −0.11 to −0.04]). Specifically, self-compassion positively predicted gratitude (β = 0.34, t = 6.80, p < 0.001), and gratitude, in turn, negatively predicted depression (β = −0.20, t = −4.42, p < 0.001). The direct effect of self-compassion on depression remained significant after controlling for gratitude (β = −0.43, t = −9.52, p < 0.001), indicating a complementary partial mediation. Bootstrap analysis with 5000 resamples further confirmed the robustness of the indirect effect.

The pivotal roles of self-compassion and gratitude in mitigating depression among young adults were explored, informing tailored intervention strategies for mental health practitioners.

To investigate potential contributors to mental fatigue after aneurysmal subarachnoid hemorrhage (aSAH) and angiographically negative subarachnoid hemorrhage (anSAH), with a focus on information processing speed, attentional control, and psychological distress.

This observational study included 101 patients (70 aSAH, 31 anSAH) and 86 controls. Neuropsychological assessments and questionnaires were conducted five months post-SAH. Mental and physical fatigue were assessed with the Dutch Multifactor Fatigue Scale, information processing speed and attentional control with the Trail Making Test and Vienna Test System Reaction Time and Determination Test, and psychological distress with the Hospital Anxiety and Depression Scale.

Patients reported significantly higher mental and physical fatigue than controls (p < .001) and information processing speed and attentional control were significantly lower (p < .05), with no differences between aSAH and anSAH groups. Severe mental fatigue was present in 55.7% of patients with aSAH and 61.3% of patients with anSAH, significantly exceeding the prevalence of severe physical fatigue (p < .05). Higher mental fatigue correlated with worse attentional control in aSAH and with lower information processing speed in anSAH. Both mental and physical fatigue correlated with psychological distress, particularly after anSAH.

The factors related to mental fatigue appear to differ based on the type of SAH, potentially involving problems in information processing speed and attentional control, psychological distress, or both. This study emphasizes the need for individualized rehabilitation strategies addressing both cognitive and psychological factors in managing mental fatigue after SAH.

This study was conducted to examine the relationship between cancer patients’ spiritual needs and their quality of life and depression levels.

This cross-sectional, exploratory study was conducted between March 2023 and November 2024. The study population consisted of cancer patients hospitalized in medical oncology departments at a university hospital in eastern Turkey. The sample consisted of 250 patients, determined by power analysis. To collect data, the “Demographic Information Form,” “Spiritual Needs Assessment Scale,” “EORTC QLQ-C30 Version 3.0 Quality of Life Scale,” and “Beck Depression Scale” were used to evaluate the patients’ sociodemographic characteristics and disease process.

There was a weak, negative, statistically significant relationship between patients’ spiritual needs and the subdimensions of the quality of life scale, specifically the general perceived health status (r = −0.297, p < 0.001), physical (r = −0.446, p < 0.001), role (r = −0.423, p < 0.001), emotional (r = −0.472, p < 0.001), cognitive (r = −0.458, p < 0.001) and social (r = −0.443, p < 0.001) functions, and finally, a weak positive correlation was found between the symptoms experienced (r = 0.376, p < 0.001) and depression levels. Additionally, a weak positive correlation between spiritual needs and depression level (r = 0.374, p < 0.001) was identified. Functional areas, depression, education level, diagnosis duration, and symptoms were identified as variables predicting spiritual needs.

In conclusion, it was determined that as the spiritual needs of cancer patients increased, their quality of life decreased and the severity of depression increased.

Adolescence is a critical period for brain maturation, influenced by stress and hormonal changes. Chronic stress can lead to increased allostatic load (AL), a cumulative measure of multisystem dysregulation, and insulin resistance (IR), both of which are linked to mental health disorders. We hypothesized that heightened AL and IR during adolescence (age 17) would predict the emergence of mood and psychotic symptoms in young adults.

This study used data from the Avon Longitudinal Study of Parents and Children, a population cohort from Bristol, United Kingdom.

Our results showed that elevated AL at age 17 was significantly associated with the development of mood disorder symptoms (MDS) and psychotic disorder symptoms (PDS) and the co-occurrence of mood and psychotic disorder symptoms (MPDS) at age 24 (p < 0.001). Mean AL increased progressively across these symptom groups, indicating a dose–response relationship between physiological dysregulation and mental health burden (MDS = 3.67, PDS = 3.89, and MPDS = 4.03). We also observed that IR was significantly elevated in the MDS, PDS, and MPDS groups compared to healthy controls (HCs). IR was most prevalent in the PDS group, suggesting a possible association between metabolic dysfunction and psychosis risk.

This study demonstrated that multisystem dysregulation in late adolescence precedes the onset of mood and psychotic symptoms in early adulthood. These results support the use of AL and metabolic markers as early indicators of psychiatric vulnerability and highlight the potential for early intervention targeting systemic dysregulation to prevent the onset of mental health disorders.

Withania somnifera (WS) is considered an adaptogen agent with reported antistress, cognition facilitating and anti-inflammatory properties, which may be beneficial in the treatment of mental disorders.

This systematic review investigated the efficacy and tolerability of Withania somnifera for mental health symptoms in individuals with mental disorders.

The protocol of this review was registered with PROSPERO (CRD42023467959). PubMed, Scopus, PsycINFO, CINAHL, Embase and CENTRAL were searched for randomised controlled trials comparing Withania somnifera to any comparator, in people of any age, with any mental disorder. The meta-analyses were based on standardised mean differences (SMDs) and odds ratios with 95% confidence intervals, estimated through frequentist and Bayesian-hierarchical models with random-effects.

Fourteen studies, corresponding to 360 people treated with Withania somnifera and 353 controls were included. Anxiety disorders were the predominant diagnostic category. Thirteen trials administered Withania somnifera orally (median dose 600 mg/day), one with Shirodhara therapy. The median follow-up time was 8 weeks. Although limited by the small number of studies, substantial between-study heterogeneity, and outlier effects, our investigation showed Withania somnifera effectiveness in improving anxiety (outlier-corrected SMD: −1.13 (95% CI: −1.65; −0.60), pooled SMD: −1.962 (95% CI: −2.66; −0.57)), depression (SMD: −1.28 (95% CI: −2.40; −0.16) and stress (SMD: −0.95 (95% CI: −1.46; −0.43) symptoms and sleep quality (SMD: −1.35 (95% CI: −1.79; −0.91). The effect size was confirmed using the Bayesian for anxiety but not for depression. No significant difference between Withania somnifera and the comparators was found for safety and tolerability.

We found evidence supporting the effectiveness of Withania somnifera in treating anxiety symptoms. Future trials should replicate this finding in larger samples and further clarify a possible Withania somnifera role in depression and insomnia treatment.

Financial strain is increasingly recognised as a contributor to psychological distress, which may in turn elevate the risk of developing mental disorder. However, few large-scale longitudinal studies have investigated its predictive role using diagnostic outcomes among higher education students.

To examine whether financial strain predicts a major depressive episode (MDE) one year later among Norwegian students, and whether associations are explained by sociodemographic factors or baseline psychological distress.

Data were drawn from the national Students’ Health and Wellbeing Study 2022 (SHoT2022) survey (N = 53 362), with a diagnostic follow-up one year later (N = 10 460) using the self-administered Composite International Diagnostic Interview version 5.0 (CIDI 5.0). Inverse probability weighted Poisson regression with robust standard errors estimated the risk of 30-day DSM-5-defined MDE for each financial indicator.

Financial strain was widespread: 6% reported frequent financial difficulties, 27% were unable to cover an emergency expense of 5000 Norwegian kroner (NOK; approximately €450/$500, and 35% spent 60% or more of their income on housing. Several indicators significantly predicted later MDE. Students frequently experiencing financial difficulties had a 3.55-fold increased risk (95% CI:2.97–4.22), attenuating to 1.53 (1.28–1.83) after full adjustment. Similar patterns emerged for most indicators. Associations were largely unaffected by sociodemographic adjustment, but were substantially reduced after accounting for baseline psychological distress.

Financial strain was associated with increased risk of MDE one year later, although much of the association was explained by baseline distress. Policies should address both financial and psychological vulnerabilities through strengthened financial support, alignment with living costs and targeted measures such as financial counselling and housing assistance.

Cardiovascular diseases (CVD) and depression frequently co-occur, yet the biological mechanisms underpinning this comorbidity remain poorly understood. This may reflect complex, non-linear associations across multiple biological pathways. We aimed to identify molecular biomarkers linking depressive symptoms and cardiovascular phenotypes using a network-based integrative approach.

Data were obtained from the Young Finns Study (N = 1,686; mean age = 37.7 years; 58.3% female), including 21 depressive symptoms (Beck Depression Inventory), 17 CVD-related indicators, 6 risk factors, 228 metabolomic, and 437 lipidomic variables. Mutual information was used to capture both linear and non-linear associations among variables. A multipartite projection network was constructed to quantify how depressive symptoms and cardiovascular phenotypes are biologically connected via shared metabolites and lipids. Biomarkers were ranked by their contribution to these projected associations. Results were validated in an independent cohort from the UK Biobank.

Specific depressive symptoms – crying, appetite changes, and loss of interest in sex – showed strong projected associations with diastolic blood pressure, systolic blood pressure, and cardiovascular health scores. Key mediators included creatinine, valine, leucine, phospholipids in very large HDL, triglycerides in small LDL, and apolipoprotein B. Important lipid mediators included sphingomyelins, phosphatidylcholines, triacylglycerols, and diacylglycerols. Replication analysis in the UK Biobank identified many overlaps in metabolite profiles, supporting generalizability.

This network-based analysis revealed symptom-specific biological pathways linking CVD and depression. The identified biomarkers may offer insights into shared mechanisms and support future prevention and treatment strategies for cardiometabolic–psychiatric comorbidity.

The association between geriatric depression and out-of-hospital cardiac arrest (OHCA) has not been fully clarified.

This study aimed to develop and validate a predictive model for OHCA in older patients through a longitudinal, population-based approach.

This study analysed data from the National Health Insurance Research Database for the period 2011–2020, focusing on older patients both diagnosed with depression and treated with antidepressant medications. A multivariate logistic regression model was used to identify potential predictors of OHCA. Considering the effect of COVID-19, data-sets from 2019 and 2020 were used as external validation. The model’s performance was evaluated using receiver operating characteristic (ROC) curves and confusion matrix metrics.

Out of 104 022 geriatric patients with depression, 2479 (2.4%) experienced OHCA. Significant predictors of OHCA included age, male gender, previous utilisation of medical resources, renal failure with haemodialysis, existing comorbidities, medication changes and recent psychotherapy. The ROC values for the predictive models ranged from 0.707 to 0.771 in the 2019 and 2020 external validations for 7-, 30- and 90-day OHCA. For 2019, the 7-day model demonstrated sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of 0.600, 0.718, 2.130, 0.560 and 3.840, respectively. For 2020, these metrics for the 7-day model were 0.775, 0.655, 2.250, 0.340 and 6.550, respectively.

This study developed and validated a predictive model for OHCA in older patients with depression. The model identified crucial predictors, providing valuable insights for psychiatrists and emergency clinicians to identify high-risk patients and implement early preventive measures.

While psychiatric disorders (e.g., depression, anxiety) are well-established predictors of suicidal ideation (SI) in individuals with traumatic brain injury (TBI), the roles of other psychological and cognitive factors remain underexplored. This study examined associations between SI and emotion-processing difficulties, coping strategies, psychological resilience, and cognitive functioning after moderate–severe TBI.

This was a secondary analysis of data from 106 individuals with moderate–severe TBI. SI and emotional distress were assessed using the Inventory of Depression and Anxiety Symptoms and Hospital Anxiety and Depression Scale, respectively. Participants also completed measures of emotional lability and detachment (Comprehensive Assessment of Traits Relevant to Personality Disorders [CAT-PD]), coping (Coping Scale for Adults), psychological resilience (Connor–Davidson Resilience Scale), and cognitive functioning, including subjective (CAT-PD, Brief Rating of Executive Function) and objective measures (Brief Test of Adult Cognition by Telephone). Spearman’s correlations and path models were used to examine psychological and cognitive correlates of SI.

SI was positively associated with emotional lability, emotional detachment, non-productive coping, and self-reported cognitive problems, and negatively associated with resilience. Path models indicated that emotional distress accounted for 76–100% of these associations. Conversely, SI was not significantly associated with adaptive coping or objective cognitive performance.

Emotion-processing difficulties, non-productive coping strategies, low resilience, and self-reported cognitive problems are linked to SI in individuals with moderate–severe TBI, primarily through their associations with emotional distress. Findings underscore the importance of addressing emotional distress, including depression and anxiety, and its underlying contributors in suicide prevention for this population.

Approximately 24% of stroke survivors develop post-stroke depression (PSD), which is associated with poor psychological recovery, identity disruption, and reduced self-esteem. Psychological interventions often fail to address these broader challenges. The Wisdom Enhancement Timeline technique, which facilitates autobiographical reflection, has shown promise for depression in older adults. It has not yet been studied in a post-stroke population.

This study evaluated the effectiveness of the Wisdom Enhancement Timeline technique in stroke. It was hypothesised that wisdom would improve first, followed by identity/self-esteem and mood.

A multiple-baseline single-case experimental design (SCED) was used across three stroke survivors. Daily visual analogue scale (VAS) ratings measured mood, identity, self-esteem, and wisdom during the trial. The Patient Health Questionnaire-9 (PHQ-9) measured depressive symptoms at pre- and post-intervention. Visual analysis, Tau-U, generalised least squares regression (adjusting for autocorrelation), and piecewise regression evaluated intervention effects.

Improvements were observed across all participants and outcomes. Tau-U analysis indicated small-to-large effect sizes across outcomes (effect size range: 0.30–0.92). Breakpoints confirmed wisdom improved first, followed by identity/self-esteem and mood last. Regression confirmed significant level shifts across all outcomes. All participants showed clinically meaningful reductions in PHQ-9 scores, operationalised as a shift from pre-intervention scores above 10 to post-intervention scores below 10.

Wisdom-based interventions could be beneficial in a stroke population, promoting improvements in mood, identity coherence, self-esteem and wisdom. The Wisdom Enhancement Timeline technique shows promise for PSD treatment, although further research is needed to validate these effects.