Comorbidity between psychosis and eating disorders: a systematic review

BACKGROUND

Comorbidity has been reported between eating disorders and psychotic illnesses such as schizophrenia, and several hypotheses regarding their relationship have been proposed. Therefore, we aimed to systematically review studies involving patients who are affected by both psychotic symptoms and eating disorders (ED).

METHOD

We systematically searched three databases for all studies describing psychotic symptoms among patients diagnosed with eating disorders. We conducted and reported the systematic review following the PRISMA statement.

RESULTS

We included 67 publications, of which 41 were case reports and 26 were descriptive studies. Most of the included studies described transient psychotic symptoms among individuals with ED or suggested comorbidity between schizophrenia and anorexia nervosa.

DISCUSSION

The included studies were highly heterogeneous. The review suggests at least three different patterns of psychopathology: 1) patients with anorexia nervosa who experience transient psychotic symptoms in correlation with severe mental or physical stress; 2) patients suffering from comorbid schizophrenia and anorexia nervosa and fulfilling diagnostic criteria for both diagnoses; and 3) patients with psychotic illness who are experiencing disordered eating as part of their psychotic illness, but do not fulfill diagnostic criteria for it. Future research could conduct psychopathological follow-up on patients enrolled in treatment for these conditions.

Trends in socioeconomic inequalities in suicide mortality over the six past decades (1960-2021): A systematic review of 49 time-trends studies

Suicide rates has steadily and significantly declined over the past decades worldwide, but this global decline may hide a more complex trends by socioeconomic status. Our systematic review aimed to summarize the existing literature on time-trends in socioeconomic inequalities in suicide mortality over the past decades. An electronic search was performed in 5 databases on March 2024 with no restrictions on location or year of publication. Studies were included if they assessed socioeconomic inequalities through a measure of education level, income level, deprivation level, or occupation class, and time-trends with respect to suicide mortality. A total of 49 articles of overall good quality met the criteria for inclusion. The study period ranged from 1960 to 2021. Study settings were primarily Europe (n = 26) and Asia (n = 11). The majority of studies demonstrated an overall increase or stability in socioeconomic inequalities in suicide mortality, particularly among the middle-aged and especially in Asia. Inequalities based on occupational status showed the strongest tendency to increase. Mental health promotion programs targeting suicidal behaviors in the most-deprived and less-educated populations are urgently warranted.

Lifetime stressor exposure is related to suicidality in autistic adults: A multinational study

Despite very high rates of suicidal thoughts and behaviors (STB) in autistic adults, the key psychosocial drivers of this phenomenon remain unknown. To investigate, we examined how lifetime stressor exposure and severity, which have been found to predict STB in non-autistic populations, related to STB in a multinational dataset of 226 autistic adults from the United Kingdom and Australia (67% female; Mage = 41.8, SD = 13.6, range = 19-73 years old). Results revealed that autistic men and women differ with respect to the count, severity, and type of stressors they experienced over the life course. Whereas autistic men were exposed to more numerous legal/crime-related stressors, autistic women experienced more stressors related to social relationships and chronic humiliation and typically experienced stressors as more severe. In addition, whereas chronic interpersonal loss was related to STB for men, acute stressors involving physical danger and lower exposure to chronic entrapment were related to STB in autistic women. These findings indicate that certain lifetime stressors may be differentially experienced, and relevant to STB, in autistic men versus women. They also suggest that screening for lifetime stressor exposure may help identify autistic individuals at greatest risk of suicide.Lay abstractWhen we encounter life events that we experience as stressful ("stressors"), it sets off a biological stress response that can impact mental health and contribute to suicidal thoughts and behaviors (STB). Although we know about specific stressors that are associated with STB in the general population, little is known about the kinds of stressors that increase the risk of STB in autistic people and whether these associations differ by gender. To examine this issue, we cataloged the life stressors that autistic men and women experienced over the entire life course and investigated how these stressors were related to STB. Data were derived from a multinational sample of 226 autistic adults from the United Kingdom and Australia who completed the Stress and Adversity Inventory for Adults. We found that autistic men and women differed in terms of both the lifetime stressors they experienced as well as their perceived severity. Whereas men experienced more legal/crime-related stressors, women experienced more stressors related to relationships with other people and more long-lasting stressors associated with humiliation. Autistic women often perceived life stressors as more severe than men, which is important given that it is the perceived severity of stressors that most strongly affects our health. We also found that different stressors may predict STB in autistic men versus women. Whereas loss of loved ones was most strongly associated with STB for men, for women, physically dangerous stressors were most relevant. In addition, women with fewer lifetime stressors involving entrapment had higher lifetime STB. These results suggest that lifetime stressor exposure may be important to assess to understand suicide risk in autistic people. Additional research is needed to confirm these associations and to examine possible mechanisms linking stress and STB.

Tailoring clinical goals to the individual is a good idea, and lessons from brain science can help

Zilcha-Mano (see record 2026-05243-001) provided several important insights relating to our recent special issue on utilizing data from brain science to better manage clinical heterogeneity (Damme & Mittal, 2024) and expanded on these ideas by emphasizing that individualized definitions of what "healthy" is an important consideration as well. We agree that tailoring treatment planning to an individual person is a very good idea, and, in a related point, we have recently argued that efforts to manage clinical heterogeneity are only as good as the quality of the outcome variables in consideration (see Kraus et al., 2024). In this commentary, we discuss potential barriers, caveats, and considerations and suggest theoretical intersections where lessons from brain research may help. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Dietary patterns derived using reduced rank regression in postmenopausal women and risk of mortality: A population-based study

OBJECTIVES

The menopause transition increases the risk of chronic conditions in women. Given the crucial role of diet in health, we identified dietary patterns that explain variations in factors related to major health concerns in postmenopausal women. Also, we explored their association with all-cause and cardiovascular mortality.

STUDY DESIGN

This study was conducted on 1814 postmenopausal women from the population-based Rotterdam Study.

MAIN OUTCOME MEASURES

Dietary patterns were identified using reduced rank regression. Response variables included bone mineral density, body composition parameters, lipid profile markers, insulin resistance, systolic blood pressure, cognitive function, depression, and sleep quality. The associations with risk of mortality were assessed using Cox proportional hazard models.

RESULTS

The first dietary pattern, characterized by higher intake of vegetables, whole grains, legumes, nuts, coffee, tea, alcoholic beverages, and cheese, explained 2.95 % of the variation in responses, accounted for 12.11 % of the variation in general cognitive function captured by G-factor, 5.62 % in systolic blood pressure, and 4.13 % in bone mineral density, and was correlated with less adiposity, lower blood pressure, lipid markers, and insulin resistance. The second dietary pattern, characterized by higher intakes of processed meat, unprocessed red meat, poultry, eggs, and coffee, and lower intakes of sweets and tea, explained 1.54 % of the variation in responses, accounted for 5.45 % of variation in fat mass percentage, 3.47 % in lean mass index, and 3.29 % in bone mineral density, and was correlated with higher adiposity, insulin resistance, and lipid markers. No associations with mortality risk were identified after adjusting for confounders such as demographics, socioeconomic status, lifestyle, disease history, and medication use.

CONCLUSIONS

We identified dietary patterns explaining a range of variation in health factors related to postmenopausal health. While these dietary patterns explained a large variation in some of the individual factors, their combined explained variation across multiple risk factors simultaneously was limited and no significant association with mortality risk was observed. This study provides a foundation for future research aimed at identifying optimal dietary patterns, integrating diverse health aspects, to improve health in postmenopausal populations.

Emerging Viral Infections (ZIKV, SARS-CoV-2, and MPXV) and Depression: Ketamine and (S, R)-Ketamine as Promising Antidepressants

Emerging viral pathogens, newly reported or rapidly evolving viruses, are a significant public health concern worldwide. Beyond their characteristic clinical presentations, emerging viruses, such as monkeypox virus (MPXV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have been increasingly implicated in the development of various neuropsychiatric complications including depression, mainly due to their ability to induce neuroinflammation, immune dysfunction, and neurotransmitter imbalances. Depression is a common mental health condition characterised by continuous low mood or sadness, pessimism, anxiety, and even a tendency to suicide as the main symptoms. Post viral depression commonly shows significant challenges, as traditional antidepressant agents exhibit suboptimal efficacy and prolonged onset of action. Regarding this, ketamine and its enantiomers, S-ketamine and R-ketamine, have recently received increasing attention as potential options in light of their potent and effective antidepressant properties. The present review describes the underlying pathophysiological mechanisms of depression associated with emerging viruses, highlighting the role of neuroinflammation and disturbances inneurotransmitter systems. It also discusses the antidepressant mechanisms of ketamine and its enantiomers, the current clinical evidence demonstrating their effectiveness and safety, especially in the case of treatment-resistant depression, and their growing relevance for mood complications linked to emerging viral infections, including depression. Although preliminary reports propose effectiveness, additional studies are needed to present optimal treatment strategies, long-term safety, and incorporation into clinical practice. Addressing these challenges will be critical for optimising the effectiveness of ketamine- and (S, R)-ketamine-containing therapeutic protocols in treating depression linked to emerging viral infections.

Metabolic syndrome in patients with schizophrenia: Underlying mechanisms and therapeutic approaches (Review)

Schizophrenia (SCZ) represents a considerable health concern, not only due to its impact on cognitive and psychiatric domains, but also because of its association with metabolic abnormalities. Individuals with SCZ face an increased risk of developing metabolic syndrome (MS), which contributes to the increased cardiovascular burden and reduced life expectancy observed in this population. Metabolic alterations are associated with both the SCZ condition itself and extrinsic factors, particularly the use of antipsychotic medications. Additionally, the link between SCZ and MS seems to be guided by distinct genetic parameters. The present narrative review summarizes the relationship between SCZ and MS and emphasizes the various therapeutic approaches for managing its components in patients with these conditions. Recommended therapeutic approaches include lifestyle modifications as the primary strategy, with a focus on behavioral lifestyle programs, addressing dietary patterns and physical activity. Pharmacological interventions include administering common antidiabetic medications and the selection of less metabolically harmful antipsychotics. Alternative interventions with limited clinical application are also discussed. Ultimately, a personalized therapeutic approach encompassing both the psychological and metabolic aspects is essential for the effective management of MS in patients with SCZ.

Mapping the gender gradient in posttraumatic stress disorder prevalence: A machine learning approach

The prevalence of posttraumatic stress disorder (PTSD) among women is over twice that of men, but the underlying mechanisms for these differences remain poorly understood. This study introduces a novel approach to examining gender and PTSD, moving beyond the binary group labels of male and female to explore the summative impact of gender-linked sociocultural factors. Using supervised machine learning, we modeled gender from theoretical and empirically selected predictors reflecting the roles, relationships, and institutional facets of gender. This model produced continuous gender scores reflecting the social circumstances typical of male (lower scores) or female (higher scores) individuals. We then examined how well these scores were associated with past-year PTSD among trauma-exposed men and women (N = 23,936) and compared effects to those obtained using binary sex. The results revealed a clear dose-response relationship between the social circumstances typical of female gender and past-year PTSD. Main effects for gender scores, adjusted odds ratio (aOR) = 4.03, 95% CI [2.64, 6.15], were substantially larger than main effects for binary sex, aOR = 2.69, 95% CI [1.96, 3.68], z = 2.30, p = .021, even after accounting for trauma exposure and other risk factors. This study highlights the importance of quantitative approaches that move beyond binary comparisons of male and female to better elucidate sociocultural determinants of traumatic stress.

Mental Health Sequelae of Cardiac Events: A Comprehensive Review of Biological Mechanisms, Prevalence, and Interdisciplinary Care Approaches

Cardiovascular diseases are the leading cause of mortality worldwide, with postcardiac events such as myocardial infarction, acute coronary syndrome, and sudden cardiac arrest causing significant physiological trauma and psychological effects. This study explores the complex interplay between cardiac events and mental health disorders, focusing on the biological and psychological pathways that connect these conditions in at-risk populations. The acute stress response following a cardiac event involves the activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, leading to the release of stress hormones and inflammatory cytokines. Prolonged activation of these systems can result in neurotransmitter imbalances, neuroinflammation, and epigenetic modifications, increasing the susceptibility to mental health disorders such as depression, anxiety, and posttraumatic stress disorder (PTSD). Women exhibit a higher vulnerability to these conditions due to hormonal fluctuations and a more pronounced stress response. The prevalence of mental health disorders following cardiac events is substantial, with PTSD rates being particularly high among survivors of myocardial infarction and out-of-hospital cardiac arrest. These psychological conditions are associated with poor physical recovery, reduced quality of life, and an increased risk of recurrent cardiac events and mortality. Resilience and adaptive coping mechanisms serve as protective factors, highlighting the importance of integrating mental health care within cardiac rehabilitation programs. This study emphasizes the need for early detection, targeted interventions, and an interdisciplinary approach to improve mental health outcomes in patients recovering from cardiac incidents. Understanding the psychiatric sequelae of cardiac events is crucial for cardiologists, particularly in the management of postmyocardial infarction patients, ischemic attack survivors, and individuals undergoing open-heart surgery. Early detection and interdisciplinary interventions can improve long-term outcomes.

Association between CAIDE risk score and episodic memory in middle-aged females: The impact of spontaneous menopause

There is growing evidence that postmenopause is associated with episodic memory decline in some females. Although midlife vascular risk factors are established predictors of brain health, it is unclear whether episodic memory decline at postmenopause is related to vascular risk, and whether such effects affect specific mnemonic functions (e.g. recollective processing vs. novelty detection). This study investigated whether vascular risk, measured by the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) score, predicts episodic memory in middle-aged females at pre- and post-menopause. Eighty-five cognitively unimpaired females (42 premenopausal, 43 postmenopausal) aged 39.5 to 65.1 years completed easy (low encoding load) and hard (high encoding load) versions of a face-location episodic memory task. Outcome measures were spatial source retrieval (correct source accuracy; CS) and detection of novel stimuli (correct rejections; CR). Linear-mixed models (LMMs) tested menopause group effects on CS and CR, while separate LMMs stratified by menopause status assessed whether CAIDE score predicted memory performance in each group. Results indicated that postmenopausal females performed worse than premenopausal females in both CS (β = 0.08, p < 0.001) and CR (β = 0.05, p = 0.011), with postmenopausal females more sensitive to task difficulty in CS. Higher CAIDE scores were associated with poorer CS accuracy in postmenopausal females only (β = -0.14, p = 0.009), with no effect on CR. These findings highlight the significance of vascular risk in episodic memory decline and emphasize the role of reproductive status in midlife cognition.

Dynamics and concordance alterations of intrinsic brain activity indices in stroke-induced Broca's aphasia varies based on first language: A resting-state fMRI analysis

OBJECTIVE

This study aimed to investigate the changes in intrinsic brain activity (IBA) among individuals with Broca aphasia (BA) after a stroke.

METHODS

We collected information from 60 participants. The participants were categorized into four groups according to language (Uyghur and Chinese) and BA status (BA and healthy): Uyghur aphasia patients (UA), Uyghur healthy control subjects (UH), Chinese aphasia patients (CA), and Chinese healthy control subjects (CH). Each group comprised 15 individuals. The shifting dynamics and concordance of regional IBA indices were examined via sliding time-window analysis. A two-way analysis of variance (ANOVA) was conducted with the IBA indices to test for regions with interactions between language and BA status. Partial correlation analysis was employed to evaluate the relationships between various indices and language behaviors.

RESULTS

Participants with head motion exceeding 3 mm translation or 3° rotation were excluded, leaving 9, 12, 13, and 15 participants in the UA, CA, UH, and CH groups, respectively. Seven IBA indices were activated in 16 brain regions in the four groups. In detail, two-way ANOVA revealed a significant interaction between language and BA status in four IBA dynamic indices (amplitude of low-frequency fluctuations (ALFF), Regional homogeneity (ReHo), degree centrality (DC), and functional connectivity (FC)) in 11 brain regions (P < 0.000). For the other three dynamic indices (fractional amplitude of low-frequency fluctuation (fALFF), Voxel-mirrored homotopic connectivity (VMHC), and Global signal connectivity (GSCorr)), no interaction was observed among the four groups. However, the main effect analysis of the BA state demonstrated significant differences across a total of six brain regions (P < 0.000). The concordance alterations in fALFF, ReHo, VMHC, DC, and GSCorr in the right calcarine fissure and the surrounding cortex were significantly lower in CA than in CH (P = 0.000), significantly higher in UA than in CA (P = 0.025), and significantly lower in UH than CH (P = 0.000).

CONCLUSION

In conclusion, alterations in IBA dynamics and concordance were observed in individuals from UA, UH, CA, and CH. These findings suggest that the IBA dynamic index varies across brain regions of BA patients with different local languages, providing a novel perspective for investigating brain alterations by analyzing temporal dynamics using rs-fMRI data.

Scoping review of the music-based movement therapy Ronnie Gardiner Method

PURPOSE

Ronnie Gardiner Method (RGM) is a music-based movement therapy that has long been used within rehabilitation. There is a need to (1) identify the scope of the use of RGM, (2) explore potential benefits, (3) examine qualitative studies to capture perspectives from participants and practitioners, and (4) identify knowledge gaps to be addressed in future research.

MATERIALS AND METHODS

A scoping review methodology was conducted. PubMed, CINAHL, Scopus, as well as the search engines DIVA portal, Libris.se, Google Scholar, and uppsatser.se were searched. Quantitative studies were summarised using diagnosis as a differentiating criterion, and qualitative studies were summarised in a narrative synthesis.

RESULTS

Twenty-three studies were included, the vast majority of which consisted of non-peer-reviewed publications/grey literature. There is initial research evidence on potential benefits for stroke rehabilitation, with inconclusive results in other populations. Qualitative data indicate that RGM is adequately challenging and motivating for participants, with positive perceptions of recovery and quality of life.

CONCLUSIONS

Findings indicate that RGM could serve as a valuable addition to neurological rehabilitation. Potential benefits were identified, and qualitative data indicate that RGM is perceived as motivating and enjoyable. Future research should employ robust study designs, including controlled trials, to further validate RGM.

Postnatal propionic acid exposure disrupts hippocampal agmatine homeostasis leading to social deficits and cognitive impairment in autism spectrum disorder-like phenotype in rats

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized by a range of symptoms including impaired social interaction and cognitive deficits. Although the exact pathogenesis of ASD is not well established, recent clinical findings suggest a decline in levels of biogenic amine agmatine in autistic patients. The present study was designed to investigate the impact of postnatal propionic acid (PPA) exposure on hippocampal agmatine homeostasis in male rat pups and to explore a new therapeutic intervention for ASD using agmatine as a biological target. PPA is commonly used in experimental models of ASD due to its ability to induce social deficits, cognitive impairments, and stereotyped behaviors, which closely resemble key characteristics of ASD. Male rat pups were administered with PPA via the intrahippocampal route bilaterally (25 μg/0.25 μl per side) on PND-21 to simulate the ASD phenotype, and its subsequent effect on the endogenous agmatinergic system. The influence of agmatine treatment and its endogenous modulation on ASD-like phenotypes was also investigated. Behavioral assessments revealed that PPA exposure reduced sociability and social preference, caused learning and memory impairment in the Morris water maze, increased anxiety-like behavior in the elevated plus maze, and reduced exploratory behavior in the hole board test. Neurochemical analyses showed a decrease in agmatine concentration and an increase in its degrading enzyme agmatinase in the hippocampus. PPA treatment altered the content of GABA, glutamate, TNF-α, IL-6, BDNF, and also resulted in increased astrogliosis and neurotoxicity within the hippocampus. Chronic agmatine treatment and its endogenous modulation ameliorated the behavioral and biochemical disruptions induced by PPA exposure. This study highlights the critical role of hippocampal agmatinergic pathway in the etiopathogenesis of ASD, positioning agmatine as a promising therapeutic target for its treatment.

Life-course perspective on the causal mechanism of social functioning in schizophrenia spectrum disorder

BACKGROUND

Due to prior emphasis on clinical recovery in Schizophrenia Spectrum Disorder (SSD), improving social functioning (SF) was oftentimes neglected, with ⩽15% of patients achieving social recovery. Priorly, we and others have shown that life-course factors, including childhood adversities, play a role in the occurrence and severity of postmorbid SF impairments, highlighting the need to understand these factors for effective interventions.

AIM

This study investigates the mechanisms influencing SF in SSD and examines the causal roles of childhood trauma, premorbid adjustment, perceived stigma, self-esteem, and quality of life.

METHODS

This longitudinal study utilized data of 1,057 SSD patients, with measures at baseline, 3 and 6-year follow-up, from the Genetic Risk and Outcome of Psychosis cohort, to unravel the causal mechanism underlying SF utilizing Structural Equation Modeling. Determinants were assessed using validated retrospective and self-report questionnaires. Model development and testing involved a multistage process, encompassing relationships exploration, fit evaluation and model comparison.

RESULTS

We developed a probable causal model. Impaired premorbid adjustment emerged as a crucial factor, exerting negative influence on long-term SF, with a direct effect of β = -.252, p < .001 on SF at 3-year follow-up and β = -.056, p = .073 at 6-year follow-up. Childhood trauma exhibited a negative direct effect on SF at 3-year follow-up (β = -.087, p = .039), while demonstrating a substantial carry-over, indirect effect. Elevated perceived stigma negatively affected SF at 3-year follow-up (β = -.112, p = .008). The model explained 9.9% of SF variation at the 3-year follow-up and 54.3% at the 6-year follow-up.

CONCLUSIONS

While validation is necessary, we found a foundational basis for causal interpretation. Premorbid adjustment, childhood trauma, and perceived stigma are essential life-course factors shaping postmorbid SF in SSD. We recommend interventions covering both prevention and treatment for individuals with established symptoms-addressing childhood trauma, premorbid adjustment, and perceived stigma-to enhance long-term social outcomes and offer actionable insights for clinicians.

Personal Norms Predict Defending in Bullying: Mediating Role of Anticipated Pride and Guilt

Recent studies have shown that bystander intervention involves moral engagement. However, the underlying internal mechanism is still poorly understood. Drawing on the norm activation model (NAM), Study 1 (questionnaire; n = 502) and Study 2 (experiment; n = 144) were conducted to investigate the influence of personal norms on defending through the mediating factors of anticipated pride and anticipated guilt. After controlling for age and gender, Study 1 revealed a significant positive association between personal norms and defending. This relationship was mediated by both anticipated pride and guilt, highlighting their parallel roles in explaining the influence of personal norms on defending. Study 2 investigated using writing tasks to manipulate personal norms from participants. The results revealed that the priming group had significantly higher levels of anticipated pride, guilt, and defending than the control group. Study 2 replicated the results of Study 1 in testing the mediated path, enhancing the reliability of research findings. This study expands the scope of the application of NAM by examining the interplay between personal norms, anticipated pride, anticipated guilt, and defending, as well as exploring the implications of these findings for interventions against bullying. Moral education should focus not only on the responsibility and obligation of bystanders to intervene in bullying incidents but also on the need to assist students in forming a moral compass within themselves that guides them to defend victims through moral emotions actively.

Latent profile analysis of fear of progression in Chinese hematologic malignancy survivors

Fear of disease progression (FoP) is a multidimensional concept that refers to the fear or worry about disease progress. Little is known about the distinct FoP profiles and their determinants in culturally specific contexts, especially among hematologic malignancies (HM) patients in China. This study aimed to identify heterogeneous profiles of FoP and their associated predictors among Chinese patients with HM. A convenience sample of patients suffering from HM were enrolled from March 2023 to February 2024. To gather multidimensional data from the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Brief Illness Perception Questionnaire (BIPQ), the Hospital Anxiety and Depression Scale (HADS), the Family Hardiness Index (FHI), and the EuroQol-Visual Analogue Scale (EQ-VAS), we performed a questionnaire-based cross-sectional study on 455 survivors with HM. The statistical method included latent profile analysis (LPA) and multivariate logistic regression. Three latent profiles of FoP were found: the low-risk fear group (20.88%), the moderate-risk fear group (54.73%), and the high-risk fear group (24.49%). Patients with higher levels of illness perception, anxiety, and depression were more likely to report higher levels of FoP. The study revealed that female gender (OR 2.295-2.577), age > 65 years (OR 4.140-9.363), lower education (OR 0.270-0.365), and lymphoma diagnosis (OR 2.95) significantly predicted higher FoP risk (all P < 0.05), while higher income (OR 0.390-0.477, P < 0.05) and greater family resilience showed protective effects. The findings underscore the need for risk-stratified interventions targeting psychosocial vulnerabilities, particularly in elderly and female adults with HM. This study provides empirical evidence supporting the application of precision psycho-oncology approaches in HM survivorship management. It also contributes to the broader comprehension of FoP and highlights the importance of family-centered interventions .

The efficacy of antenatal Cognitive Behavioural Therapy for antenatal and postnatal depression: A PRISMA based systematic review and meta-analysis

BACKGROUND

Considerable research has assessed the effectiveness of Cognitive Behavioural Therapy (CBT) for perinatal depression, however limited attention has been paid to its effectiveness when delivered during pregnancy. The primary aim of this review was to review evidence of the efficacy of CBT interventions delivered antenatally to treat symptoms of depression in women during the antenatal and postnatal periods. The review's secondary aim was to evaluate potential moderators of treatment outcome.

METHODS

Electronic Databases; CINAHL, PsycINFO, Medline, Scopus, and Web of Science were searched for studies that employed CBT in response to symptoms of depression in pregnant women. Randomized control trials were included if they compared outcomes for pregnant women with outcomes of inactive controls. A systematic review and meta-analysis was conducted on n = 12 eligible studies.

RESULTS

CBT yielded statistically significant, within and between groups' effects on depressive symptoms during the antenatal period. CBT delivered at that time also yielded smaller yet statistically significant within and between groups' effects on depressive symptoms experienced postnatally. CBT was found to be more effective for women of greater age, higher number of weeks gestation, or who were multiparous. The facilitator of treatment, delivery mode, the assessment measures used to evaluate treatment outcome, and symptom severity also moderated treatment outcome.

LIMITATIONS

Significant publication bias and heterogeneity were evident across studies indicating a need to focus future research.

CONCLUSIONS

Overall, findings support the use of CBT delivered antenatally to reduce depression experienced during, and following, pregnancy.

Proposing the Integrated Pathway Model of Moral Injury (IPM-MI): A Moderated Mediation Analysis of Moral Injury Among Secure Mental Healthcare Staff

Moral injury is a prevalent issue for secure mental healthcare staff, though understanding of the underlying mechanisms is limited. This multi-study paper explores several developmental, cognitive and emotional pathways to moral injury and associated wellbeing outcomes. Frontline and support staff from secure mental healthcare services were recruited to two cross-sectional studies (n = 527 and n = 325, respectively), and completed several questionnaires. In the first study, findings indicated a serial mediating effect of childhood trauma symptoms, early maladaptive schemas, and maladaptive metacognitions in the pathway between exposure to potentially morally injurious events and moral injury symptoms. Moderating effects of social and organisational support were also apparent. Findings from study two supported pathways between moral injury and psychological, somatic and functional outcomes, which were mediated by negative emotional schema, with limited mediating effects for expressive suppression. Moderating effects of alexithymia on several mediating pathways were also noted. The results support a developmental-cognitive model to account for the development of moral injury and associated adverse well-being outcomes in secure mental healthcare staff. Drawing on the findings and wider literature, the Integrated Pathway Model of Moral Injury (IPM-MI) is proposed and discussed, offering a novel theoretical account that may inform several potential prevention and intervention strategies.

Significance of NMDA receptor-targeting compounds in neuropsychological disorders: An In-depth Review

N-methyl-D-aspartate receptors (NMDARs), a subclass of glutamate-gated ion channels, play an integral role in the maintenance of synaptic plasticity and excitation-inhibition balance within the central nervous system (CNS). Any irregularities in NMDAR functions, whether hypo-activation or over-activation, can destabilize neural networks and impair CNS function. Several decades of experimental and clinical investigations have demonstrated that NMDAR dysfunction is implicated in the pathophysiology of various neurological disorders. Despite designing a long list of compounds that differentially modulate NMDARs, success in developing drugs that can selectively and effectively regulate various NMDAR subtypes while showing encouraging efficacy in clinical settings remains limited. A better understanding of the basic mechanism of NMDAR function, particularly its selective regulation in pathological conditions, could aid in designing effective drugs for the treatment of neurological conditions. Here, we reviewed the experimental and clinical investigations that studied the effects of available NMDAR modulators in various neurological disorders and weighed up the pros and cons of the use of these substances on the improvement of functional outcomes of these disorders. Despite numerous efforts to develop NMDAR modulatory drugs that did not produce the desired outcomes, NMDARs remain a significant target for advancing novel drugs to treat neurological disorders. This article reviews the complexity of NMDAR signaling dysfunction in different neurological diseases, the efforts taken to examine designed compounds targeting specific subtypes of NMDARs, including challenges accompanied by using these substances, and the potential enhancements in drug discovery for NMDAR modulatory compounds by innovative technologies.

Infection, inflammation, and sexual function in male and female patients-recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024)

INTRODUCTION

Sexual dysfunction in men and women is an important clinical issue; infection and inflammation can cause social, medical, and psychological problems that have a profound impact on sexual and reproductive health worldwide.

OBJECTIVES

We set out to identify sexual dysfunctions in men and women that arise from infection and inflammation and propose meaningful interventions, as evaluated by the Fifth International Consultation on Sexual Medicine (ICSM) held in June 2024 in Madrid (Spain).

METHODS

We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for published peer-reviewed journal articles and ClinicalTrials.gov and the World Health Organization's (WHO's) International Clinical Trials Registry Platform for prospective trials. This manuscript represents the opinions of 10 experts from 6 countries developed in a consensus process after completing the literature review, which produced a list of recommendations graded as weak or strong. This document was presented for peer review and debate in a public forum, and revisions were made based on the recommendations of chairpersons of the 5th ICSM.

RESULTS

Infections, and in particular sexually transmitted infections (STIs), dramatically affect the sexual and reproductive health of individuals and couples, irrespective of sexual orientation and gender. Similarly, non-communicable chronic diseases (NCDs), through the common pathogenetic mechanism of inflammation, can directly impair the ability to copulate, reproduce, and enjoy sexual life.

CONCLUSIONS

This expert consensus recommends prioritizing early detection, comprehensive treatment approaches, and preventive measures to mitigate the effects of infection and inflammation on sexual health, both for the patient and the couple. These insights provide a foundation for improving patient outcomes and fostering global awareness of the interconnections between infection, inflammation, and sexual dysfunction.

A randomized, controlled trial to evaluate the efficacy of pyridoxine and ascorbic acid on cognitive function and quality of life in post-menopausal women

This study is conducted to investigate and contrast the effect of pyridoxine and ascorbic acid on mild cognitive impairment and quality of life in post-menopausal women. A randomized, controlled trial was carried out involving post-menopausal women with mild cognitive impairment. A total of 180 eligible participants were randomized to group A (25 mg of pyridoxine), group B (100 mg of ascorbic acid), and group C (not receiving any drug). The intervention time was 6 months. The Montreal cognitive assessment (MoCA) scale was utilized to assess cognitive function. Serum beta-amyloid (Aβ) 42 and homocysteine (Hcy) levels were measured. We used the menopause-specific quality of life (MENQOL) questionnaire to evaluate the quality of life (QOL) of post-menopausal women. Both pyridoxine and ascorbic acid have improved total MoCA scores (p = 0.0323 and p = 0.0074) compared to baseline. The Hcy level was reduced significantly in pyridoxine than in ascorbic acid (p = 0.0060). The serum Aβ 42 decreased significantly with pyridoxine and ascorbic acid (p = 0.0311 and p = 0.0042). In the MENQOL score, ascorbic acid has significantly reduced the score of the physical domain (p = 0.0020). However, a significant reduction in the overall score of MENQOL was not noticed before and after the treatment of pyridoxine and ascorbic acid (p = 0.3724 and p = 0.0732). Pyridoxine is more effective than ascorbic acid in lowering Hcy levels among post-menopausal women. Pyridoxine and ascorbic acid have been shown to improve cognitive function, and further long-term research is imperative to validate these findings. The trial was registered in the Clinical Trial Registry of India and registration no. is CTRI/2023/03/051131. Registered on: 28/03/2023-trial registered prospectively.

Telepsychiatry in Africa: overcoming barriers to access and care

Telepsychiatry presents a transformative opportunity to address Africa's significant mental health challenges. With a high prevalence of psychiatric disorders and limited access to care, particularly in rural and marginalized communities, innovative solutions are urgently needed. This paper has explored the potential of telepsychiatry to overcome geographical barriers and address the shortage of mental health professionals in Africa. Despite its potential, telepsychiatry faces challenges such as technological barriers, stigma, and regulatory issues. However, these challenges can be addressed with concerted efforts from governments, healthcare organizations, and communities. Developing robust regulatory frameworks, investing in infrastructure, and promoting cultural sensitivity are essential steps towards realizing the full potential of telepsychiatry in Africa. Looking to the future, telepsychiatry holds promise for revolutionizing mental healthcare delivery on the continent. Through continued research, evaluation, and innovation, telepsychiatry can become a cornerstone of mental healthcare provision, ensuring that no one is left behind in accessing the care they need.

Prevalence and predictors of metabolic syndrome among psychiatric patients receiving antipsychotic treatment in Africa: a systematic review and meta-analysis

BACKGROUND

Antipsychotic medications, though essential for treating severe mental illnesses, are commonly associated with metabolic side effects that increase the risk of metabolic syndrome (MetS). These metabolic complications significantly undermine treatment adherence and contribute to adverse clinical outcomes. Despite the increasing utilization of antipsychotics in Africa, there remains a critical lack of region-specific data on the prevalence and determinants of metabolic syndrome in this population. This systematic review and meta-analysis aims to synthesize existing data on the prevalence and predictors of MetS among psychiatric patients receiving antipsychotic treatment in Africa.

METHOD

We looked for primary papers on PubMed/MEDLINE, Scopus, African Journal Online, PsycINFO, EMBASE, Psychiatry Online, CINAHL, Science Direct, and the Cochrane Library. We included original research articles that evaluated the prevalence of metabolic syndrome among psychiatric patients treated with antipsychotic medication. Two independent reviewers examined the articles and extracted data. The I² statistic was employed to assess statistical heterogeneity, and a random-effects meta-analysis was applied due to the observed heterogeneity. Publication bias was evaluated using a funnel plot and Egger's weighted regression test. This review has been registered with PROSPERO (ID = CRD42024558310).

RESULTS

This systematic review analyzed 25 primary studies encompassing a total of 4,064 participants. The pooled prevalence of metabolic syndrome among psychiatric patients receiving antipsychotic treatment in Africa was estimated at 22% (95% CI: 16.33-27.66). Female gender (OR = 3.28, 95% CI: 1.73-6.23), advanced age (OR = 1.07, 95% CI: 1.03-1.12), and elevated body mass index (OR = 5.33, 95% CI: 2.35-12.12) were identified as significant risk factors for metabolic syndrome in this population.

CONCLUSION

Metabolic syndrome is highly prevalent among psychiatric patients receiving antipsychotic treatment in Africa, with female sex, older age, and elevated body mass index identified as significant risk factors. These findings underscore the need for routine metabolic monitoring and timely interventions to mitigate cardiovascular risk, enhance treatment adherence, and prevent recurrence of psychiatric symptoms.

Schizophrenia-like phenotypes and long-term synaptic plasticity impairment in GluN2A-transgenic mice

While N-methyl-d-aspartate receptor (NMDAR) hypofunction has been suggested as a hallmark of schizophrenia, the role of subunit-specific dysregulation such as GluN2A overexpression remains poorly understood. The present study comprehensively investigated the impact of GluN2A overexpression on behavioral phenotypes, cognitive functions, and synaptic plasticity in transgenic mice with forebrain-specific overexpression of the GluN2A subunit (GluN2A-TG). Behavioral assessments revealed schizophrenia-like phenotypes, including prolonged stereotypic movement duration, impaired sensorimotor gating, reduced social interaction, and diminished nest-building activity in GluN2A-TG mice. Consistently, GluN2A-TG mice exhibited not only deficits in spatial working memory and olfactory working memory but also impaired associative learning. In addition, both long-term potentiation and long-term depression were significantly attenuated in the prefrontal cortex (PFC) of GluN2A-TG mice. Furthermore, electrophysiological analysis of NMDAR-mediated excitatory postsynaptic currents in PFC neurons revealed altered kinetics characterized by a faster decay time and significantly increased amplitude in GluN2A-TG mice. Collectively, these findings suggest that GluN2A overexpression may induce schizophrenia-like phenotypes via impairing NMDAR-dependent long-term synaptic plasticity in the PFC, likely due to altered NMDAR subunit composition leading to disrupted calcium signaling dynamics. These results provide critical insights into the pathological role of GluN2A in schizophrenia.

Biofeedback-Enhanced Cognitive-Behavioral Therapy Delivered Virtually to Youth With Inflammatory Bowel Disease: A Randomized Controlled Trial

BACKGROUND

Inflammatory bowel diseases (IBDs) are increasingly recognized as products of the brain-gut axis associated with dysfunctions of the chronic stress response systems. The objectives of this study were to evaluate the feasibility, acceptability, and preliminary efficacy of a virtual, group-based heart rate variability (HRV) biofeedback-enhanced coping skills intervention for youth with IBD. Treatment targets included symptoms of anxiety, depression, gastrointestinal (GI) symptoms, and perceived stress.

METHODS

Youth with IBD (ages 13-18) and their caregivers were randomized to either immediate treatment or waitlist control groups. The intervention consisted of 6 virtually delivered, weekly group sessions combining cognitive-behavioral therapy (CBT) with HRV biofeedback training. Outcomes included measures of anxiety, depression, GI symptoms, perceived stress, and HRV parameters. Assessments were conducted at baseline and post-intervention.

RESULTS

Of the 53 youth randomized, 50 participated in their assigned group. The intervention demonstrated strong feasibility with 84% of participants attending at least 4 of 6 sessions. Both adolescents and parents reported strong satisfaction. Following treatment, parents reported significant decreases in adolescent depressive symptoms, anxiety symptoms, and GI symptoms compared to controls. Adolescents reported reductions in GI symptoms and perceived stress compared to controls and reductions in symptoms of anxiety within the treatment group. No changes were observed in HRV parameters.

CONCLUSIONS

This pilot study supports the feasibility and acceptability of a virtual, group-based HRV biofeedback-enhanced coping skills intervention for youth with IBD. Preliminary efficacy was demonstrated for reducing psychological and physical symptoms. Future research should evaluate efficacy in a larger, more diverse sample with elevated baseline psychological symptoms.

Biotechnological approaches for the production of neuroactive huperzine A

Huperzine A (HupA), a natural Lycopodium alkaloid primarily derived from Huperzia serrata, has gained attention for its potent neuroprotective properties, particularly its ability to inhibit acetylcholinesterase and modulate key neurological pathways. This review highlights HupA's therapeutic potential in managing neurodegenerative disorders such as Alzheimer's disease, Parkinson's disease, Huntington's disease, Multiple sclerosis, Epilepsy, and Myasthenia gravis drawing on a comprehensive literature survey of in vitro, in vivo, and clinical investigation data. Given the limited yield from natural sources, this review also focuses on biotechnological strategies to enhance HupA production. These include chemical synthesis, microbial fermentation using endophytic fungi, plant tissue culture, and emerging synthetic biology approaches. Key biosynthetic intermediates and enzymes, such as lysine decarboxylase, copper amine oxidase, and cytochrome P450s, are discussed in the context of metabolic pathway elucidation and engineering. The review emphasizes the need to bridge current knowledge gaps in HupA biosynthesis to develop cost-effective, sustainable production methods. Advances in metabolic pathway elucidation and engineering hold immense potential for scalable biosynthetic production. Ultimately, the integration of HupA into neurotherapeutic regimens, coupled with innovations in its production, could revolutionize the management of neurodegenerative disorders and position it as a cornerstone of future multi-targeted treatment strategies.

Mental health of persons with disabilities during the COVID-19 pandemic in Bangladesh

BACKGROUND

The COVID-19 pandemic has impacted the mental health of people across the world, including those with disabilities in Bangladesh. However, very little research exists that has explored the mental health problems experienced by persons with disabilities in rural and urban areas of Bangladesh. This study aimed to investigate the prevalence and associated factors of common mental health problems in persons with disabilities in rural and urban areas of Bangladesh.

METHODS

A cross-sectional survey using the Bangla Depression Anxiety Stress Scale-21 (BDASS-21) with sociodemographic was conducted among 950 participants with varying types of disabilities in Dhaka, Narayanganj, and Gazipur. Descriptive and inferential statistical analyses were used to measure the effects.

RESULTS

The prevalence of moderate to extremely severe depression, anxiety, and stress among participants was 67.6%, 72.6%, and 49.5%, respectively. Urban participants exhibited significantly higher levels of depression (76.6% in Dhaka), anxiety (86.1% in Dhaka), and stress (32.1% in Dhaka) compared to their rural counterparts (depression: 86.16%, anxiety: 91.07%, stress: 97.77% in Gazipur). Gender differences were observed in anxiety, with females reporting higher anxiety levels than males (p<0.05). Age and geographical location were significantly associated with stress (p<0.042 and p<0.001, respectively), with those reporting higher anxiety also experiencing greater stress (p<0.001). Specific disabilities, such as visual disabilities, were linked to higher stress levels, while depression and anxiety did not show significant associations with demographic factors or disability type.

CONCLUSION

Results highlight the prevalence of common mental health problems among persons with disabilities in Bangladesh. The findings can contribute to the development of appropriate public health intervention plans taking into consideration persons with disabilities, especially during emergencies.

Mobile phone addiction was the mediator and physical activity was the moderator between bullying victimization and sleep quality

BACKGROUND AND OBJECTIVES

Bullying victimization is strongly associated with sleep quality issues in primary school students, yet the underlying mechanisms among these variables require further exploration. This study investigates the mediating role of mobile phone addiction and the moderating role of physical activity in the relationship between bullying victimization and sleep quality among primary school students, contributing to a deeper understanding of these psychological processes.

METHODS

This study utilized a convenience sampling method to recruit 502 primary school students in 2023. The sample included 232 boys and 270 girls, with ages ranging from 10 to 12 years (mean age = 11.15 ± 0.62). Participants were recruited from specific region or school district to ensure a diverse representation of the target population. Ethical approval was obtained from the relevant institutional review board, and informed consent was obtained from both the students and their parents or guardians prior to data collection.

RESULTS

Bullying victimization was significantly positively correlated with both sleep quality issues and mobile phone addiction. Additionally, mobile phone addiction was significantly positively correlated with sleep quality issues. The analysis confirmed that mobile phone addiction mediates the relationship between bullying victimization and sleep quality. Furthermore, physical activity was found to moderate the relationship between bullying victimization and mobile phone addiction.

CONCLUSIONS

This study elucidates the psychological mechanisms underlying the relationship between bullying victimization and sleep quality among primary school students. Mobile phone addiction serves as a mediating factor, while physical activity acts as a moderating factor in the link between bullying victimization and mobile phone addiction. These findings underscore the importance of addressing mobile phone addiction and promoting physical activity as part of targeted interventions to improve sleep quality among primary school students.

Media Discourse, Influence, and Reflection: Content Analysis and Text-Mining Study of Suicides and Homicides in Long-Term Care

BACKGROUND

As populations age, the demand for long-term care services steadily increases. The effectiveness of government-promoted long-term care policies and the public's access to relevant service information are demonstrably influenced by media representation. In addition, prior research has suggested that news framing can mitigate the negative influence (the Werther effect) with a more hopeful framing (the Papageno effect), thereby reducing the public's susceptibility to negative news.

OBJECTIVE

This study investigates the phenomenon of suicides and homicides in long-term care reported in the news, in which family caregivers or care receivers died by suicide or homicide. We examined changes in the media's reporting framework before and after the implementation of Taiwan's Long-Term Care Plan 2.0 in 2017. We further examined the consistency between the content of news reports and the information provided by the media on long-term care services and suicide prevention (eg, hotlines).

METHODS

Content analysis and text-mining techniques were used to analyze 433 news reports covering 95 cases of suicides and homicides in long-term care in Taiwan from 2009 to 2021. A random-effects model was applied to examine term frequency transition post implementation.

RESULTS

The majority (>60%) of the cases involved family caregivers' homicide-suicide. The term "family moral tragedy" has been replaced by "long-term care tragedy" in recent discourse. This shift is evident in a decline in the frequency of "family moral tragedy" since 2017, with usage decreasing by 32.4% in headlines and by 24% in news content. The term frequency of "care burden" has significantly increased from 0.0006 (SD 0.0008) to 0.017 (SD 0.0461; t337=3.006; P=.003). While linguistic characteristics of the content have remained consistent, there were statistically significant differences in medical and ethics-related terms. The media tends to provide more suicide prevention information (eg, hotlines; >50%), offering relatively limited coverage on long-term care services (<25%).

CONCLUSIONS

The news media have the potential to change the public's response to specific issues. Our findings suggest that government efforts to encourage media coverage of positive experiences with long-term care services can be a preventative measure against caregiving suicides and homicides. Moreover, government initiatives should focus on strengthening media publicity and enhancing media literacy within the long-term care sector. By empowering the media to provide readers with clear channels for seeking help, such as hotlines, the media will contribute positively to the mental health of family caregivers. Finally, an annual database on family caregiver homicide-suicide should be established. In that case, the government could identify potential risk factors and inform the formulation and revision of relevant policies and services via this database, ultimately contributing to preventing suicides and homicides in long-term care and achieving public health goals.

Time dependent predictors of cardiac inflammatory adverse events in cancer patients receiving immune checkpoint inhibitors

BACKGROUND

Cardio-inflammatory immune related adverse events (irAEs) while receiving immune checkpoint inhibitor (ICI) therapy are particularly consequential due to their associations with poorer treatment outcomes. Evaluation of predictive factors of these serious irAEs with a time dependent approach allows better understanding of patients most at risk.

OBJECTIVE

To identify different elements of patient data that are significant predictors of early and late-onset or delayed cardio-inflammatory irAEs through various predictive modeling strategies.

METHODS

A cohort of patients receiving ICI therapy from January 1, 2010 to May 1, 2022 was identified from TriNetX meeting inclusion/exclusion criteria. Patient data collected included occurrence of early and later cardio-inflammatory irAEs, patient survival time, patient demographic information, ICI therapies, comorbidities, and medication histories. Predictive and statistical modeling approaches identified unique risk factors for early and later developing cardio-inflammatory irAEs.

RESULTS

A cohort of 66,068 patients on ICI therapy were identified in the TriNetX platform; 193 (0.30%) experienced early cardio-inflammatory irAEs and 175 (0.26%) experienced later cardio-inflammatory irAEs. Significant predictors for early irAEs included: anti-PD-1 therapy at index, combination ICI therapy at index, and history of peripheral vascular disease. Significant predictors for later irAEs included: a history of myocarditis and/or pericarditis, cerebrovascular disease, and history of non-steroidal anti-inflammatory medication use.

CONCLUSIONS

Cardio-inflammatory irAEs can be divided into clinically meaningful categories of early and late based on time since initiation of ICI therapy. Considering distinct risk factors for early-onset and late-onset events may allow for more effective patient monitoring and risk assessment.

Immunity in neuromodulation: probing neural and immune pathways in brain disorders

Immunity finely regulates brain function. It is directly involved in the pathological processes of neurodegenerative diseases such as Parkinson's and Alzheimer's disease, post-stroke conditions, multiple sclerosis, traumatic brain injury, and psychiatric disorders (mood disorders, major depressive disorder (MDD), anxiety disorders, psychosis disorders and schizophrenia, and neurodevelopmental disorders (NDD)). Neuromodulation is currently a leading therapeutic strategy for the treatment of these disorders, but little is yet known about its immune impact on neuronal function and its precise beneficial or harmful consequences. We review relevant clinical and preclinical studies and identify several specific immune modifications. These data not only provide insights into how neuromodulation acts to optimize immune-brain interactions, but also pave the way for a better understanding of these interactions in pathological processes.

Applications of Self-Driving Vehicles in an Aging Population

Unlabelled

The proportion of older adult drivers is increasing and represents a growing population that must contemplate reducing driving and eventually stopping driving. The advent of self-driving vehicles opens vast possibilities with practical and far-reaching applications for our aging population. Advancing technologies in transportation may help to overcome transportation barriers for less mobile individuals, transcend social and geographical isolation, and improve resource and medical access. Herein, we propose various applications and benefits that self-driving vehicles have in maintaining independence and autonomy specifically for our aging population to preserve aging.

Climate Anxiety and COPD: Unveiling Its Impact on Patients' Quality of Life Through a Multivariate Lens

OBJECTIVE

To examine the impact of climate anxiety on the quality of life (QoL) of patients with COPD. It also explores how climate anxiety interacts with clinical factors, such as disease severity and comorbidities, to influence QoL.

DESIGN

Cross-sectional.

METHODS

A total of 270 COPD patients were recruited using a convenience sampling method. Data were collected through structured interviews and clinical assessments, incorporating the Climate Anxiety Scale, the St. George's Respiratory Questionnaire and the BODE Index. Hierarchical multiple regression analysis was performed to determine the predictors of QoL.

RESULTS

The study found a statistically significant association between climate anxiety and both QoL (r = 0.81, p < 0.01) and COPD severity (r = 0.76, p < 0.01). COPD severity (B = 4.68, p < 0.01) and climate anxiety (B = 0.28, p < 0.01) were predictors of QoL. Among the covariates, former smokers, older patients and multiple comorbidities reported significantly worse QoL (B = 4.80, p = 0.03; B = 0.43, p < 0.01; B = 0.85, p = 0.02, respectively). Collectively all predictors explained 86% of the variance in QoL.

CONCLUSION

Climate anxiety significantly contributes to reduced QoL in COPD patients, beyond disease severity and demographic factors. Addressing psychological distress in COPD management is essential to improving patient outcomes.

IMPLICATIONS FOR PRACTICE

Nurses should recognise climate anxiety as a key variable influencing COPD management. Incorporating climate anxiety screening into nursing assessments and providing targeted interventions can enhance patient support and improve overall COPD care.

IMPACT

Climate anxiety is an emerging concern in COPD. While previous research has focused on physical and clinical determinants of COPD-related QoL, climate anxiety remains underexplored. This study provides new evidence that climate anxiety is a predictor of poorer QoL, highlighting the need for holistic nursing interventions that address both physical and psychological health.

REPORTING METHOD

This study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).

PATIENT OR PUBLIC CONTRIBUTION

Patients with COPD were involved in this study.

Effectiveness of telepsychiatry interventions for youth with depressive and/or anxiety disorders: A systematic review with meta-analysis

ObjectiveSince the onset of the COVID-19 pandemic, rates of anxiety and depression in youth have risen. Telepsychiatry is a potential mode of intervention for such digital natives. This systematic review aims to examine the effectiveness of telepsychiatry for youth with depression and/or anxiety.MethodsFour electronic databases, PubMed, MEDLINE, Embase, PsycINFO, were searched from their inception to May 12, 2024. Included studies were assessed for study quality and risk of bias.ResultsA search returning 29,944 records yielded 26 included studies, comprising 1,558 youths. Of 13 studies comparing depressive symptoms pre- and post-telepsychiatry intervention, symptom severity was significantly lower post-intervention compared to baseline (Hedges' g: 0.83; 95% CI: 0.59, 1.08). Similarly, of six studies comparing pre- and post-telepsychiatry intervention anxiety symptoms, anxiety scores were significantly lower post-intervention (Hedges' g: 1.15; 95% CI: 0.79, 1.50). Patients undergoing telepsychiatry also had superior outcomes when compared to waitlist control groups for depression (Hedges' g: 0.54; 95% CI: 0.23, 0.85) but not anxiety (Hedges' g: 0.50; 95% CI: -0.09, 1.10). Certainty of these estimates ranged from moderate to very low. Qualitative feedback noted subjective improvement in symptoms and high levels of satisfaction.ConclusionTelepsychiatry has potential as a therapeutic intervention for youth anxiety and depression. Further research with more controlled methodology is needed for development of recommendations that can guide growing use of this technology.

Medical management of ADHD in adults: part 1

Attention deficit hyperactivity disorder (ADHD) in adults is common, impairing and often unrecognised. Comorbidity is very common and may compound the impact of ADHD. It is important that a diagnosis of ADHD is made following a high-quality assessment. Symptoms and social outcomes can be improved by treatment, particularly medication. Non-pharmacological treatment may be more effective in those who are also on medication, and psychoeducation and environmental modifications are also important. Stimulants such as methylphenidate and lisdexamfetamine are recommended first choice medications. The choice of drug can be tailored to patients' circumstances, especially intended duration of action, then titrated week by week, according to response.

Healthy, moderate, or distressed: identification of latent profiles of mental health of a Chilean older primary care user sample

BACKGROUND

In older adults, medium and high levels of life satisfaction can coexist with mental health symptoms. The combination of these variables continues to be a challenge for public mental health; even more so for middle-income countries where evidence is scarce. This study aimed to identify latent mental health profiles in a sample of older adults attending primary healthcare centres (PHC) in the Province of Concepción, Chile.

METHODS

A convenience sample of individuals aged 65 and older who sought care in 15 PHC centres was recruited. Perception of well-being and the presence of anxiety and depression symptoms, all of these in relation to variables such as age, sex, cohabitation, health history, alcohol use, social participation, social support, loneliness, stressful events, presence of previous major depressive episodes, and generalized anxiety disorders. The relationship between the variables was analysed using a latent profile model.

RESULTS

A total of 573 interviews were conducted, with 7.85% having a psychiatric diagnosis in the last year. Four latent profiles were identified: healthy (15%); moderate mental health with lower anxiety (22%), moderate mental health with higher anxiety (34%), and distressed (29%). The multinomial regression model for predictor variables significantly predicted the class for each subject. Key predictors include loneliness, stressful events, satisfaction with health status, and sex.

CONCLUSIONS

The combined assessment of mental distress variables (anxiety and depressive symptoms) and well-being forms a gradient ranging from positive (healthy) and negative (distressed) mental health, with anxiety playing a crucial role in its differentiation.

Sigma-1 receptor agonist PRE-084 increases BDNF by activating the ERK/CREB pathway to rescue learning and memory impairment caused by type II diabetes

Sigma-1 receptor (Sig-1R) agonists has therapeutic effects in neurological disorders and possesses properties that can reverse cognitive dysfunction. This study investigated the therapeutic efficacy of Sig-1R activation on cognitive dysfunction in streptozotocin (STZ) combined with high fat and high sugar diet (HFD)-induced type 2 diabetic rats. By employing morris water maze (MWM) testing and computed tomography (CT) imaging, we observed that activation of Sig-1R effectively mitigated brain atrophy and cognitive impairment in diabetes-induced cognitive impairment (DCI) rats. Given the fundamental role of intact hippocampal synaptic plasticity in maintaining cognitive function, we investigated the correlation between Sig-1R and Brain-Derived Neurotrophic Factor (BDNF), a well-established neurotrophic factor. And we also analyzed the expression of Postsynaptic density protein-95 (PSD95) protein. Golgi staining, Haematoxylin-eosin (HE) staining, Nissl staining, and immunofluorescence results show that activating Sig-1R can upregulate BDNF expression and reducing synaptic damage in hippocampal neurons. To elucidate the mechanism by which Sig-1R activation leads to increased BDNF levels, we investigated the Extracellular Signal-Regulated Kinase/Cyclic AMP Response Element-Binding Protein(ERK/CREB) protein pathway. In vitro and in vivo, we observed that Sig-1R activates the ERK/CREB signaling pathway, thereby stimulating BDNF release and increased PSD95 expression. Further intervention with BD1047 antagonist and Tropomyosin-Related Kinase B (TrkB) antagonist ANA-12 confirmed our conclusion that Sig-1R activation upregulated p-ERK and p-CREB protein expression, promoted BDNF transcription, the expression of PSD95 protein was up-regulated, reduces synaptic damage in damaged hippocampal neurons, and rescued cognitive impairment in DCI rats.

Genetic approach uncovering the pathways between childhood maltreatment and suicide attempt

Childhood maltreatment significantly heightens the risk of suicide attempt, but the causal mechanisms and underlying pathways are not fully understood. Using genetic instruments for both childhood maltreatment (n = 185,414) and suicide attempt (cases = 29,782; controls = 519,961), we performed two-sample Mendelian randomization analyses. Our results show that higher level of childhood maltreatment is causally associated with an increased risk of suicide attempt (OR = 3.40; 95% CI, 2.34-4.96, P = 1.3e-10). We then conducted a two-step Mendelian randomization mediation analysis, identifying 11 out of 58 potential mediators between childhood maltreatment and suicide attempt. These mediators included neurobiological, psychopathological and behavioral factors. The psychopathological factors had the most significant impact, accounting for 10.4-50.2% the mediation. This study confirms the causal relationship between childhood maltreatment and suicide attempt, highlighting specific mediators-especially within the psychopathological dimension-that can guide targeted interventions to alleviate the adverse effects of childhood maltreatment and prevent suicide attempt.

Lower- versus higher-order suicide-related attentional processing measures as predictors of adolescent suicide ideation and attempt

Cognitive theories suggest that biased suicide-related attentional processing confers risk for suicide ideation (SI) and attempts (SAs), but studies to date, which have been mixed, have not compared lower- and higher-order measures of attentional processes. The present study examined attention fixation, attention disengagement, and semantic interference as predictors of future SI and SA among adolescents, a high-risk age group for onset of SI and SAs. Adolescents (N = 135) (75 % female), ages 12-19 (M = 15.4, SD = 1.9), who presented to emergency or outpatient departments with SI (n = 84) or a SA (n = 51) completed an attention disengagement task (ADT), Suicide Stroop task, and the Attentional Fixation on Suicide Experiences Questionnaire (AFSEQ). A subsample of adolescents completed 3-month (n = 98) and 12-month follow-up assessments (n = 96) of SI severity and SA (n = 118) (based on adolescent or caregiver report). AFSEQ score predicted SI severity at 3- and 12-months, respectively, b = 0.47, p < .05; b = 0.44, p < .01, adjusting for ADT and relevant covariates, and also predicted SA at follow up, OR = 1.06, 95 % CI = 1.00-1.12, p < .05, adjusting for SA history, but not after adjusting for SI. Greater suicide-related attention disengagement difficulty predicted greater SI severity at 12 months, b = 0.03, p < .05, but not at 3 months. Self-reported, higher-order, attentional fixation may better predict future suicide-related risk among diverse adolescents than lower-order cognitive tasks assessing suicide-related attention disengagement or semantic interference.

Associations between suicidal ideation and childhood maltreatment as well as inflammatory cytokines in adolescents with major depressive disorder

Suicidal ideation (SI) is thought to be associated with childhood maltreatment (CM) and inflammatory processes. Yet, these links are not thoroughly studied in adolescents with major depressive disorder (MDD). So, this study focused on investigating the predictive value of CM and inflammatory cytokines for SI in this population. This study included 156 depressed adolescents. The Center for Epidemiological Studies Depression Scale (CES-D), the Childhood Trauma Questionnaire (CTQ) and the Positive and Negative Suicidal Ideation Scale (PANSI) were used to assess depression, CM and SI, respectively. Additionally, plasma inflammatory cytokines levels were measured, including interleukin (IL)-1β, IL-6, IL-10, IL-17A and tumor necrosis factor-α (TNF-α). Univariate analyses showed that females had higher levels of SI in adolescents with MDD. Moreover, the level of SI was negatively correlated with age and age at onset, and positively correlated with duration of illness, CES-D score, CTQ score, as well as levels of IL-1β, IL-6 and TNF-α (all p < 0.05). Furthermore, regression analyses revealed that SI was independently associated with age at onset, CES-D score, CTQ score, and Log IL-1β (all p < 0.05). Finally, receiver operating characteristic (ROC) curve analyses revealed that the combination of the CES-D score, CTQ score, and IL-1β (AUC = 0.910, 95% CI 0.864-0.956, p < 0.001) had a better ability to identify SI in adolescents with MDD, exhibiting higher sensitivity and specificity. SI is associated with depressive symptoms, CM and elevated levels of inflammatory cytokines (especially IL-1β) in adolescents with MDD. In the future, interventions such as cognitive behavioural therapy and the administration of anti-inflammatory drugs, targeting the modulation of CM and inflammatory cytokine levels, may play important roles in preventing suicidal behaviors in depressed adolescents.

Chronic emotional stress and mediating role of Interleukine-6 in the association with cardiometabolic disorders in a multiethnic middle-aged and older US-population

Introduction

Chronic emotional stress is a well-recognized risk factor for psychiatric and cardiometabolic disorders. The mediating role of low-grade inflammation in older, ethnically diverse populations has never been studied.

Methods

The multiethnic ≥ 50-year-old study population is a subset of the Health and Aging Brain Study: Health Disparities (HABS-HD) study. Adjusted logistic and linear regression were used to assess associations. Statistical mediation analysis with non-parametric bootstrapping was used to determine the intermediate role of Interleukine-6 (IL-6).

Results

The study included 2,173 participants (50-92 years). Hispanic and Black participants disclosed higher chronic stress levels than White participants. Having a chronic stress total score ≥ six points is associated with 53% higher odds of disclosing concomitant cardiovascular disease (CVD) (adj.OR=1.53 [1.1-2.53]), 31% of Type-2 diabetes (T2DM) (adj.OR=1.31[1.06-1.62]), 23% of hypertension (adj.OR=1.23 [1.02-1.49]), and 30% obesity (adj.OR=1.3[1.09-1.55]). These associations were statistically mediated by IL-6 (12% ( p-value FDR =0.012) of the association with CVD, 17% T2DM ( p-value FDR <0.001), 18% hypertension ( p-value FDR <0.001), and 29% obesity ( p-value FDR =0.005)).

Conclusions

The study highlights a further aspect of the pathophysiological mechanisms involved in brain-body communication. While IL-6 partially explains statistical associations between chronic emotional stress and major cardiometabolic disorders, potential causal effects need to be explored in larger longitudinal studies.

Sexual dimorphisms in innate immune activation markers in predementia Alzheimer's disease

Females have an increased risk of developing Alzheimer's disease (AD). The innate immune system plays a key role in AD pathology, and sex differences in innate immune responses may contribute to differences in disease risk and progression. This study investigated sex differences in innate immune responses among participants without cerebrospinal fluid (CSF) determined amyloid pathology [A-; cognitively normal (CN), n = 83] and those with amyloid pathology (A+, n = 202), further stratified into preclinical (CN with A+, n = 72) and mild cognitive impairment (MCI with A+, n = 130). Participants were drawn from the Norwegian Dementia Disease Initiation cohort (n = 285). We measured plasma glial fibrillary acidic protein (GFAP) and CSF concentrations of nine innate immune markers: soluble triggering receptor expressed on myeloid cells 2 (sTREM2), monocyte chemoattractant protein 1 (MCP-1), fractalkine, chitinase 3-like 1 (YKL-40), clusterin, interferon gamma (IFN-γ), interleukin-6 (IL-6), IL-10, and IL-18. Linear regression was used, adjusted for multiple comparisons using the false discovery rate. In A+ cases (n = 202, females = 105), females had lower MCP-1 (P  < 0.01), IL-6 and IL-18 (both P  < 0.05) than males, while no sex differences were observed in A- cases (n = 83, females = 39). Among A+ participants, no sex differences were observed in CN cases (n = 72, females = 37), but females (n = 68) with MCI had lower MCP-1 and IL-6 (both P  < 0.05) than males (n = 62) with MCI. Moreover, A+ females exhibited stronger positive associations between sTREM2 and clusterin with CSF total tau (P < 0.001; P < 0.05) and Neurofilament light chain (P < 0.01; P < 0.01) than males. These findings suggest sex-specific differences in innate immune responses, which may contribute to disease progression in amyloid-positive individuals.

Development and validation of a nomogram for predicting depression risk in patients with chronic kidney disease based on NHANES 2005-2018

BACKGROUND

Depression is common among patients with chronic kidney disease (CKD) and is associated with poor outcomes. This study aims to develop and validate a nomogram for predicting depression risk in patients with CKD.

METHODS

This cross-sectional study utilized data from the 2005-2018 National Health and Nutrition Examination Survey (NHANES) database. Participants were randomly divided into training and validation sets (7:3 ratio). A nomogram was developed based on predictors identified using Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression. Model performance was evaluated using ROC curves, calibration curves, and decision curve analysis.

RESULTS

A total of 4414 participants were included. Gender, age, race, poverty-to-income ratio, diabetes mellitus, cardiovascular diseases, trouble sleeping, sleep hours, and smoking were included as predictors in the nomogram. The area under the curve (AUC) of the nomogram for predicting depression risk in patients with CKD was 0.785 (95% CI: 0.761-0.809) in the training set and 0.773 (95% CI: 0.737-0.810) in the validation set. The corrected C-index, calculated using bootstrap resampling, was 0.776, indicating good predictive performance. Calibration curves and decision curve analysis showed good calibration and clinical utility. Subgroup and sensitivity analyses further confirmed the robustness of the nomogram. A web-based risk calculator based on the nomogram was developed to enhance clinical applicability. A flowchart demonstrating the application of the nomogram for risk assessment and clinical decision-making in routine practice is provided.

CONCLUSIONS

This nomogram effectively predicts depression risk in patients with CKD and may serve as a user-friendly tool for the early identification of patients with CKD at high risk for depression using key demographic, comorbid, and lifestyle factors.

Effects of Pharmacological Treatment on Telomere Length and the Expression of Telomerase/Shelterin-Related Genes in Rat Models of Autism

Telomeres are increasingly recognized for their potential role in the etiology of autism spectrum disorder (ASD) due to their involvement in cellular aging and telomerase-shelterin function. Although shorter telomeres have been observed in individuals with ASD, studies linking telomere dynamics in blood cells and brain regions remain limited. Using the valproic acid (VPA, 500 mg/kg) rodent model, this study aimed to assess the impact of three drugs commonly used in ASD treatment (amitriptyline, risperidone, and nooclerin) on telomere length and the expression of telomerase/shelterin-related genes (Dkc1, Gar1, Pot1a, Pot1b, Tep1, Terc, Terf2ip, Tert, Tinf2, Tnks, Tpp1, Trf1, and Trf2) in blood cells, the prefrontal cortex, and hippocampus of VPA-exposed Wistar rats. Telomere length and gene expression were measured using quantitative PCR. Risperidone treatment in VPA males resulted in telomere elongation and increased expression of Tnks in blood cell and Trf1, Trf2 genes in prefrontal cortex. Nooclerin treatment also showed beneficial effects on telomere length of blood cell in males, alongside increased Trf1 expression. Long telomeres in male blood cells were associated with reduced anxiety, while a positive correlation was found between Tpp1 expression and stereotypical behavior in both male and female VPA rats. These findings suggest that nooclerin and risperidone influence telomere length and gene expression related to the telomere-telomerase complex in a sex-dependent manner, offering insights into the neurobiological mechanisms underlying ASD.

Cumulative risk for comorbidity of depression and anxiety in young people

BACKGROUND

Depression and anxiety often co-occur, resulting in a more severe prognosis than either condition alone. Identifying the impact of risk factors on this comorbidity is essential for guiding early interventions.

METHOD

Data from 4563 young participants in the Growing Up in New Zealand (GUiNZ) longitudinal study were analysed to identify risk factors associated with comorbid depression and anxiety. Scores for depression and anxiety symptoms were converted into binary variables using the cut-off of 10 and 60, respectively, and then combined to create the comorbidity outcome. A Cumulative Risk (CR) score was used to measure the impact of multiple risk factors from prenatal to childhood on the likelihood of this comorbidity. CR scores were further grouped into three levels of risk, and their association with comorbidity was examined using univariable and multivariable logistic regression analyses.

RESULTS

The prevalence of comorbidity at age 12 years was 8.9% (406/4563). Among young people, 14.2% (647/ 4563) had no risk factors, 64.7% (2953/4563) had one to three (low CR score level), and 21.1% (963/4563) had four or more risk factors (high CR score level). In the adjusted analyses, young people in the low and high CR levels had 2.6 times and 4.6 times higher odds, respectively, of experiencing comorbidity compared to those with no risk factors.

DISCUSSION

The risk of comorbid depression and anxiety symptoms increases with the number of risk factors experienced from prenatal to childhood. Multi-faceted interventions targeting several risk factors are recommended to improve youth mental health.

Bullying victimization and associated factors among school-aged adolescents in Africa: a systematic review and meta-analysis

BACKGROUND

Bullying victimization during school age is a global public health concern. School-aged adolescents experiencing bullying victimization are more likely to encounter physical, cognitive, and mental health issues; including greater rates of depression, anxiety, and suicidal behaviors. This systematic review and meta-analysis was conducted to estimate the pooled prevalence of bullying victimization and its determinants among school-aged adolescents in Africa.

METHODS

All studies reporting the prevalence of bullying victimization and its determinants among African school-aged adolescents were included based on the predefined eligibility criteria. We followed the Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA), a guideline for reporting a systematic review and meta-analysis. A random-effects model was employed to estimate the pooled effect size of bullying victimization and its determinants with their odds ratio (OR) and a 95% confidence interval(CI). Funnel plots analysis and Egger's regression test were conducted to assess publication bias. Subgroup and sensitivity analyses were also performed.

RESULTS

Twenty-five studies involving 41,716 school-aged adolescents were included in this systematic review and meta-analysis. The overall pooled prevalence of bullying victimization among school-aged adolescents in Africa was 46.35%, with a 95% CI (41.45, 51.24). According to the subgroup analysis of the study region, 49.17% of bullying victimization was reported in the Eastern region of Africa whereas, 32.73% was reported in the Southern region. Engaging in physical fights [OR=1.86; 95% CI: 1.66, 2.07], current substance use [OR=1.85; 95% CI: 1.31, 2.62], feeling lonely [OR=1.98; 95% CI: 1.49, 2.65], and being worried [OR=2.56; 95% CI: 2.12, 3.1] were significantly associated with bullying victimization.

CONCLUSION AND RECOMMENDATION

This review revealed that the pooled prevalence of bullying victimization among school-aged adolescents in Africa was high. To ensure adolescents' mental health and cultivate productive manpower, fostering a supportive environment in schools is mandatory.

Disability and Bullying Victimization Among Adolescents in Nepal: The Influence of Community Gender Norms

PURPOSE

Bullying victimization affects the well-being and academic success of children and adolescents, especially those with disabilities. However, bullying victimization is underexplored in low-middle-income countries. This study investigates the relationship between disability status and bullying victimization while exploring the role of gender norms on this relationship and examining gender differences in Nepal.

METHODS

The sample consisted of 593 Nepali school-going adolescents across 19 municipalities. Logistic regression analyses were conducted to examine the relationship between disability status, measured by Washington Group Short Set on Functioning, and bullying victimization, measured by Reduced-Aggression-Victimization Scale. We then tested if community gender norms moderated this relationship. Subgroup analyses were then conducted by gender.

RESULTS

Eight percent of adolescents reported disabilities and bullying, respectively. Adolescents with disabilities had significantly higher odds of experiencing bullying victimization compared to their nondisabled peers (B = 0.99, p = 0.01). Community gender norms moderated this relationship, such that adolescents with disabilities living in communities with more gender unequal norms had a heightened risk of bullying victimization (B = 6.84, p = 0.02). Subgroup analysis indicated that the relationship between disability status and bullying victimization was stronger for boys than girls.

DISCUSSION

Our findings highlight the vulnerability of adolescents with disabilities to bullying victimization and the need for gender-sensitive interventions in schools and communities. Targeting harmful gender norms in schools may mitigate bullying victimization for students with disabilities. Further research is needed in low-middle-income countries to explore the role of gender norms on bullying victimization in larger and diverse samples.

Psychometric properties of the Turkish version of the demoralization Scale-II and the association between demoralization and sociodemographic and disease-related factors in Turkish cancer patients

BACKGROUND

Life-threatening conditions such as cancer can evoke demoralization, which is characterized by feelings of meaninglessness, hopelessness, and helplessness. Assessing demoralization in cancer patients is crucial. This study aimed to evaluate the psychometric properties of the Turkish version of the Demoralization Scale-II (TDS-II) and explore its relationship with sociodemographic and disease-related factors.

METHODS

This study included 287 cancer patients, 265 of whom completed the final analysis. The participants completed the TDS-II, the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder Questionnaire-7 (GAD-7). The psychometric evaluation of the TDS-II involved assessments of convergent, construct, and discriminant validity and internal consistency.

RESULTS

Structural validity analysis indicated that both single-factor and two-factor models demonstrated comparable model fit, with CFI and NFI values ranging from 0.903 to 0.944 and SRMR values below 0.05. However, internal discriminant validity was not supported, as the average variance extracted (AVE) values for each factor in the two-factor model were lower than the square of their correlation coefficient. Strong correlations between the TDS-II and the, PHQ-9 and GAD-7 supported convergent validity. The internal consistency was high, with a Cronbach's alpha of 0.93 for the TDS-II. Demoralization scores were significantly higher among women, patients with a family history of cancer, and those with stage IV disease.

CONCLUSIONS

The Turkish version of the Demoralization Scale-II (TDS-II) is reliable for assessing demoralization in cancer patients and has strong psychometric properties. Screening for demoralization in high-risk groups may help prevent the progression of long-term psychological disorders.

Targeting to miR-130b-5p/TLR4: How sodium danshensu suppresses inflammatory response of microglia in cerebral ischemia-reperfusion injury

Cerebral ischemia reperfusion injury (CIRI) is a crucial process in the inflammatory response. Sodium danshensu (SDSS) is of protective effects in cardiovascular and cerebrovascular diseases due to its anti-inflammatory properties. Studies have demonstrated that SDSS administration reduces infarct volume, attenuates neurological impairment, and inhibits microglia activation in rat models of CIRI. While it is well established that miRNAs play roles in a wide range of diseases through multiple pathways. However, the mechanism by which SDSS alleviates inflammatory injury after CIRI and its potential interaction with miRNAs remain unclear. Thus, we aimed to investigate the effectiveness and mechanism of SDSS in CIRI, and to verify whether it exerts anti-inflammatory effects by affecting miRNA. Through bioinformatics analysis and experimental validation, we identified miR-130b-5p is a key gene in the CIRI process, with SDSS administration leading to an upregulation of miR-130b-5p that is indispensable for its anti-inflammatory effects. Moreover, both SDSS and miR-130b-5p reduced the expression of TLR4. Overall, the beneficial effects of SDSS on CIRI can be attributed to the up-regulation of miR-130b-5p and the inhibition of TLR4, resulting in the attenuation of the inflammatory response.