Societal pronatalist ideologies link womanhood to motherhood and create social pressures that often cause psychological distress when unmet. While previous research has documented the impact of these external pressures, much less is known about how women’s internal belief systems shape their responses to societal expectations. Recognising this gap, we examined the perspectives and concerns about motherhood and childlessness among child-free Greek women, their psychological distress and the potential mediating role of early maladaptive schemas (EMS) in this relationship. To provide context, we compared these findings with those of mothers, considering both their mental health and their assessments of similar issues after becoming parents.

We conducted an online, cross-sectional survey comparing child-free Greek women and mothers aged 30–50 years. Through custom-designed questionnaires, we evaluated concerns about motherhood and childlessness among child-free women, and we asked the mother group to assess the same aspects post-motherhood. Mental health was assessed using Depression, Anxiety and Stress Scale 21, while EMS were measured with the Young Schema Questionnaire. We used mediation analysis to examine whether EMS mediated the connection between pronatalist pressures and mental health outcomes.

The study included 1341 women, comprising 503 without children and 838 with children. Child-free women, who were predominantly involuntarily child-free, tended to be younger, more educated and had lower household incomes than mothers. They also reported more diverse sexual orientations, higher levels of depression and anxiety and elevated scores on EMS, which appear to exacerbate distress caused by societal pronatalist pressures. In contrast, mothers were typically older and more financially stable. Although they reported fulfilment from motherhood, they also faced challenges, including demanding caregiving responsibilities and financial or logistical barriers to having more children. Mothers’ psychological profiles were characterised by lower EMS scores and less overall distress.

This study revealed distinct demographic and psychological profile differences between child-free women and mothers. Our findings underscore that women’s mental health in the context of reproduction is shaped by a complex interaction of social pressures, psychological schemas and structural factors. Specifically, EMS – particularly in the domains of Emotional Deprivation, Mistrust/Abuse and Vulnerability to Harm – were identified as a key mechanism, mediating the relationship between pronatalist pressures and psychological distress. Furthermore, occupational disparities emerged as a significant stressor, affecting both child-free women in high-pressure careers and mothers who were home-makers.

Psychosis and bipolar I disorder are severe mental disorders with significant adverse impacts on patients, their families and society overall. Patients’ follow-up in rural areas is often challenging owing to stigma and limited access to mental health services.

The primary aim was to evaluate the effectiveness of follow-up by a mobile mental health unit (MMHU) operating in underserved rural areas of Crete in preventing readmissions to hospital across its 10 years of operation. Additionally, we investigated sociodemographic and clinical factors associated with patients’ readmissions.

The study included 288 patients with psychosis (n = 201) or bipolar disorder (n = 87). The effectiveness of the MMHU is assessed by comparing patients’ voluntary and involuntary admissions pre- and post-follow-up.

Hospital readmissions were reduced by half and involuntary readmissions by 50–70%. This effect was significant for patients with both single and multiple prior admissions. Regression analysis revealed that older age, depot medication, no substance misuse history and being ever married were associated with reduced readmissions. Also, the normative visit frequency of 5–9 visits per year (approximately 1 visit every 1.5 months) was associated with reduced readmissions.

The operation of an MMHU in rural Crete is effectively preventing overall and involuntary readmissions, particularly when patients are followed up on a regular basis. These findings highlight the effectiveness of community services in addressing the mental health needs of people living in rural and remote areas with limited access to mental health services.

Menopausal transition is a period of psychological vulnerability, yet suicidality remains underassessed. Hormone replacement therapy (HRT) may influence mood symptoms, but its mental health effects – particularly regarding suicidality – are poorly understood.

To evaluate changes in depressive symptoms, menopause-related distress and suicidality among menopausal women attending a specialist clinic, and explore whether outcomes differed across HRT regimens and baseline risk factors.

We analysed routinely collected data from 957 women attending a UK menopause clinic. All participants received some form of treatment following their initial consultation. Participants completed the Patient Health Questionnaire-9 (PHQ-9) and Menopause Depression Rating Scale (MENO-D) at baseline and follow-up (2–6 months later). Mixed-design analyses of variance assessed changes over time, including interaction effects for HRT type and baseline risk factors (body mass index (BMI), smoking, suicidality, antidepressant use).

Depressive symptoms and menopause-related psychological distress significantly declined over time (around 46% reduction on average). The largest improvements were observed among women receiving oestrogen–progesterone–testosterone combinations, although similar gains were also seen in oestrogen–progesterone and oestrogen–testosterone groups. Suicidality (PHQ-9 item 9) decreased by 92% among those with baseline ideation, but this was not moderated by HRT type. Self-worth (MENO-D item 4) also improved, but similarly showed no significant moderation by HRT regimen. Higher BMI was associated with worse baseline mental health, but did not moderate treatment outcomes.

Combined HRT, including formulations with testosterone, was associated with substantial improvements in mental health outcomes. Suicidality was a distinct symptom profile, often underdetected by general depression scores. However, findings are exploratory and should be interpreted cautiously because of the lack of a control group, observational design and small sample sizes in some subgroups. These results highlight the need for menopause-sensitive mental health assessments and integration of psychological screening into routine menopausal care.

Substance use disorder (SUD) is a rapidly growing public health challenge in developing countries across socioeconomic divides. In sub-Saharan Africa, the situation of SUD is particularly concerning and largely unexplored, with projections indicating a worsening trend.

This study seeks to fill the gap by generating insights into the multifaceted nature of alcohol and drug use disorders among a young adult population in Nigeria.

This is a cross-sectional survey of 192 current students at a university of a metropolitan city in North-Western Nigeria, using the NIDA-Modified ASSIST version 2.0, adapted from the Alcohol, Smoking and Substance Involvement Screening Test.

About half of the participants (49.7%) were heavy drinkers, 36.5% and 56.8% reported past year tobacco smoking and use of prescription drugs for non-medical reasons, but only 7.4% had used illegal drugs daily in the past year. Cannabis and sedatives were the most used substances in the lifetime (56.2% and 47.9%, respectively) and past 3 months (52.4% and 51.1%, respectively). Men had greater odds of substance use in their lifetime (odds ratio 4.167, 95% CI 1.61–10.77; d.f. = 1, P = 0.003) and past three months (odds ratio 6.059, 95% CI 2.20–16.69; d.f. = 1, P ≤ 0.001), compared with women.

The burden of SUD remains a major public health concern in Nigeria despite existing legislation, regulations and policies in the country. There is an urgent need improve diagnostic, treatment and preventative resources by engaging a massive public health campaign to alert the public of the dangers of SUD.

Studies have demonstrated that high job strain and low job satisfaction can lead to depression. However, less focus has been recorded on the effects of a worker’s perceived challenges related to their qualifications.

We aimed to investigate the association between perceived professional under-challenge or overload and depressive symptoms (also stratified by gender), based on nationally representative longitudinal data, thereby adding methodological novelty to previous cross-sectional research approaches.

This study used longitudinal data from the nationally representative German Ageing Survey covering community-dwelling individuals aged 40–64 years. The analytic sample included 7487 observations from 4362 individuals, spanning 4 survey waves (2008–2017). Key variables were depressive symptoms (measured with the 15-item Center for Epidemiologic Studies Depression Scale), perceived occupational challenge (via self-report) and relevant time-varying covariates (age, marital status, net household income, self-rated health, chronic diseases). Linear fixed-effects regressions were used to analyse longitudinal associations.

Fixed-effects regressions showed that transitions towards overload were significantly associated with increased depressive symptoms (β = 1.39, P < 0.01), while transitions towards not being sufficiently challenged showed no significant associations. When stratified by gender, similar patterns were observed for men, with significant associations between overload and increased depressive symptoms (β = 2.16, P = 0.004).

Our study indicates that changes towards job overload are linked to increased depressive symptoms in middle-aged men, emphasising the importance of managing work challenges and fostering a healthy work environment for employees’ mental health.

Electroconvulsive therapy (ECT) is considered among the safest and most effective treatments for mental disorders. In Nepal, ECT is practised but data regarding its use, techniques and protocols are limited. The use of non-modified ECT in Nepal is also debatable concerning ethical issues and its outcomes.

To explore the characteristics of ECT practice, its availability in psychiatric services and to determine the standards and techniques of ECT practice in Nepal.

A cross-sectional, descriptive study via an online survey with a questionnaire was used. All hospitals providing in-patient psychiatric services in Nepal were included in the study. Data were collected using Google Forms with a URL link. Questionnaires were sent to the psychiatrist at each facility. Ethical approval was obtained from Nepal Health Research Council (reference no. 2352).

Of 32 centres, 31 responded (96.9%). ECT practice was employed in 23 (74.2%) of these; 14 (60.9%) had a written ECT protocol and 95.7% obtained written family consent. Pre-ECT work-up was performed in all cases. Brief-pulse devices were used in 81.8% (n = 18), with bitemporal placement being most common. Modified ECT was practised in 16 (69.6%) centres; 4 (17.4%) used both modified and unmodified ECT and 3 (13%) used only unmodified ECT – mainly due to lack of either equipment or an anaesthesiologist. Propofol (82.8%, n = 18) and ketamine (31.8%, n = 7) were the most commonly used anaesthetics, and all centres used succinylcholine for modified ECT. Catatonia (95.7%, n = 22) was recorded as the most common indication.

This nationwide survey shows that ECT is widely used in Nepal, mainly in the form of modified bitemporal ECT, although some centres are still relying on unmodified ECT due to limited resources.

Adverse childhood experiences (ACEs), including abuse, neglect and household challenges, have been linked to various mental health outcomes, including psychosis and bipolar symptoms. Research indicates a 57–80% increased risk of psychosis among individuals exposed to ACEs.

This study examines the relationship between ACEs and psychotic/bipolar symptoms in Kenyan adolescents, assessing resilience as a potential moderator or mediator.

This cross-sectional study was conducted in Nairobi and Kiambu counties, Kenya. A total of 1972 youth, aged 14–25 years, were recruited and completed questionnaires focusing on ACEs (Trauma and Distress Scale), psychosis/bipolar symptoms (Washington Early Recognition Center Affectivity and Psychosis screen) and resilience (Adult Resilience Measure +16). Descriptive statistics, Pearson correlation and multiple linear regression were used to assess the relationships between ACEs and psychosis/bipolar symptoms. SPSS Process macro was employed to examine the moderating/mediating role of resilience.

Emotional abuse and physical abuse were significantly associated with higher psychosis and bipolar symptoms (P < 0.001). Emotional neglect negatively impacted bipolar symptoms (P = 0.042). Resilience moderated the relationship between sexual abuse and psychosis, but not bipolar symptoms. Mediation analysis showed that resilience partially mediated the relationships between sexual abuse and both psychosis and bipolar symptoms.

ACEs, particularly emotional and physical abuse, are significant predictors of psychosis and bipolar symptoms in Kenyan youth. Resilience may play a key role in moderating and mediating these relationships, particularly in cases of sexual abuse. Developing resilience-focused interventions could help mitigate the long-term effects of ACEs on mental health.

Work characteristics play a crucial role in the mental well-being of physicians. However, limited research in Bangladesh has explored the association between these characteristics and specific mental health outcomes such as depression, anxiety and stress among physicians, particularly in relation to gender differences.

This study aimed to explore the link between various work characteristics and mental health outcomes among male and female physicians in Bangladesh.

We conducted a cross-sectional study among physicians working in various healthcare settings in Bangladesh. The data were collected online between November 2023 and January 2024 using a convenience sampling technique. Work characteristics, including job characteristics, social characteristics and organisational characteristics, were assessed using previously validated scales. Mental health, on the other hand, was measured using the Depression, Anxiety and Stress Scale (DASS-21). We performed logistic regression analyses adjusted for the covariates, and further stratified by gender, to explore potential differences in work characteristics and mental health outcomes between male and female physicians.

In our study, social characteristics were significantly inversely associated with depression (adjusted odds ratio 0.37 (0.20–0.71)), anxiety (adjusted odds ratio 0.53 (0.30–0.92)) and stress (adjusted odds ratio 0.45 (0.26–0.81)). Organisational characteristics showed a significant inverse association only with stress (adjusted odds ratio 0.42 (0.24–0.74)). Among male physicians, organisational characteristics were significantly inversely associated with depression (adjusted odds ratio 0.42 (0.19–0.90)), anxiety (adjusted odds ratio 0.44 (0.21–0.91)) and stress (adjusted odds ratio 0.42 (0.20–0.89)), while social characteristics were significantly inversely linked only to stress (adjusted odds ratio 0.43 (0.19–0.97)). By contrast, among female physicians, only social characteristics demonstrated a significant inverse association with depression (adjusted odds ratio 0.30 (0.12–0.78)).

This study highlights the importance of social characteristics as a protective factor for psychological well-being in the healthcare context. Therefore, fostering a work culture that prioritises peer support and strong interpersonal relationships can be crucial in alleviating mental health challenges among physicians.

During the pivotal college years, mental health emerges as a paramount concern, with implications for academic success, personal growth and overall well-being.

To investigate the dynamics of mindfulness and self-compassion, exploring their roles in enhancing the mental well-being of 246 young Iranian adults in full-time university study during the academic year of 2022–2023.

Utilising standardised questionnaires and structural equation modelling, we examined the relationships between participants’ mindfulness, self-compassion and cognitive emotion regulation and their mental health.

Mindfulness, self-compassion and adaptive cognitive emotion regulation showed positive correlations with mental health. Adaptive cognitive emotion regulation emerged as a key mediator in the relationship between self-compassion and mental health (P < 0.05). However, maladaptive cognitive emotion regulation showed no significant relation.

Interventions aimed at enhancing mindfulness, self-compassion and adaptive cognitive emotion regulation hold promise in improving the mental health of young adults in full-time study.

Unhealthy eating patterns, physical inactivity and alcohol misuse are commonly reported by individuals with severe mental illness (SMI) and significantly contribute to premature mortality. People with SMI could benefit from psychoeducational interventions focused on lifestyle modification.

To evaluate the effectiveness of the LIFESTYLE programme to improve dietary habits and physical activity levels and reduce alcohol use in individuals with SMI versus controls receiving a less structured psychoeducational programme (Italian Ministry of University and Research, trial registration number: 2015C7374S).

This multicentre randomised controlled trial (RCT) was conducted across six Italian universities and included 401 participants diagnosed with SMI, randomly allocated to either the test group or a comparison group.

At 1-year follow-up, generalised estimating equations showed that the trial intervention boosted the likelihood of higher weekly metabolic equivalents of task (METs) expended on total activity (odds ratio 1.43, 95% CI 1.08–1.89; p < 0.01), on walking (odds ratio 1.50, 95% CI 1.18–1.90; p < 0.001) and on moderate activity (odds ratio 1.85, 95% CI 1.24–2.77; p < 0.01). Improvements in dietary habits included increased intake of fish (odds ratio 1.67, 95% CI 1.45–1.97; p < 0.05), fresh fruit (odds ratio 1.36, 95% CI 1.05–1.76; p < 0.05) and vegetables (odds ratio 1.91, 95% CI 1.56–1.96; p < 0.05), along with reduced junk food consumption (OR = 0.81, 95% CI 0.63–0.99; p < 0.05) and daily alcohol use (odds ratio 0.70, 95% CI 0.52–0.95; p < 0.05).

The LIFESTYLE intervention proved effective in promoting healthier lifestyles among individuals with SMI, with sustained benefits at 1 year. This structured programme could be a valuable addition to routine mental healthcare.

Although timely dementia diagnosis is a global healthcare priority, delays between symptom onset and formal recognition remain common, particularly in regions with limited awareness and high stigma. Such delays are associated with worse clinical outcomes, greater caregiver burden and increased healthcare costs. We report the first large-scale study of diagnostic delays in the United Arab Emirates (UAE) and the wider Middle East and North Africa, with findings relevant to other Gulf Cooperation Council countries, given the region’s unique demographic and cultural landscape.

To investigate the duration between dementia symptom onset and formal diagnosis, and to identify demographic and clinical factors associated with prolonged delays.

We retrospectively analysed 825 patients diagnosed with dementia over 10 years at a major governmental hospital in Abu Dhabi. The duration of undiagnosed symptoms (DUS) was calculated and multivariable regression was performed, adjusting for age, gender, nationality, dementia subtype and presenting symptoms.

The mean DUS was 34.7 months (s.d. = 28.8), with a median of 24 months (interquartile range 12–48 months). Older adults (≥65 years) experienced longer delays than younger patients. Symptom profile strongly influenced DUS: patients presenting with memory complaints (forgetfulness) had the longest delays, whereas those with behavioural or psychiatric symptoms, such as agitation, hallucinations or disinhibition, were diagnosed earlier. In multivariable regression, older age and memory-related presentations remained independent predictors of longer DUS while gender, nationality and dementia subtype were not significant.

Dementia diagnosis in the UAE is delayed by nearly 3 years, driven mainly by age and presenting symptoms. Reducing these delays through public awareness campaigns, clinician training and pilot primary care screening programmes could improve patient outcomes and reduce the growing health economic burden in the region.

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

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

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

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

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