Human papillomavirus (HPV) infection has a negative impact on quality of life (QoL) and sexual function, mainly owing to increased levels of anxiety and distress.

To examine the potentially moderating effects of general psychological health on the relationships between (a) HPV-related psychosocial burden and QoL and (b) HPV-related psychosocial burden and sexual function.

The HPV Impact Profile, Female Sexual Function Index, General Health Questionnaire-28 and Life Satisfaction Inventory questionnaires were completed by 151 women.

HPV-related psychosocial burden and general psychological health accounted for 23.2% of QoL variability. There was not strong evidence for a moderating effect of general psychological health on the relationship between HPV-related psychosocial burden and QoL. Higher HPV-related psychosocial burden predicted worse sexual function on average. However, HPV-related psychosocial burden accounted for only 4.1% of sexual function variability.

Higher HPV-related psychosocial burden is associated with lower QoL as well as worse sexual function. General psychological health predicts changes in QoL over and above HPV-related psychosocial burden; thus, a deep understanding of emerging mental health issues soon after diagnosis is crucial to improve counselling and enhance women’s mental empowerment to achieve a better psychological response.

Depression screening in primary care has been widely discussed, but its economic implications have remained largely unexplored. The GET.FEEDBACK.GP randomised controlled trial evaluated feedback interventions after depression screening in primary care. The study arms were (a) feedback provided to the general practitioner; (b) feedback to both the patient and the treating general practitioner; and (c) a control group without feedback. Analysis of clinical effectiveness revealed that feedback interventions were not associated with decreased depression severity. Their economic implications were the subject of this study.

To evaluate the economic impact of general-practitioner- and patient-targeted feedback following depression screening for adults in German primary care.

A cost-effectiveness analysis from a societal perspective of feedback interventions after depression screening with a time horizon of 12 months was conducted. Direct and indirect costs were estimated. Quality-adjusted life years were calculated on the basis of the EQ-5D-5L, and incremental cost-effectiveness ratios and cost-effectiveness acceptability curves based on the net monetary benefit were constructed. Sensitivity analyses and post hoc explorative subpopulation analyses were performed. Trial registration: ClinicalTrials.gov, NCT03988985.

In total, 987 participants who screened positive for at least moderate depression were included. Feedback provision was not significantly associated with changes in costs or quality-adjusted life years during follow-up. Cost-effectiveness probabilities of feedback interventions were lower than 50% compared with no feedback. Higher cost-effectiveness probabilities were observed in patients whose suspected depression was confirmed 1 month post-screening and in those with previous depression.

The analysed feedback interventions cannot be considered to be cost-effective for the investigated population. Patient-targeted feedback was potentially cost-effective for subpopulations, particularly patients with a later confirmed depression diagnosis; this requires further research.

Studies have shown that klotho, a neuroprotective protein, plays a crucial role in neurodevelopment. However, its association with attention-deficit hyperactivity disorder (ADHD), the most prevalent neurodevelopmental disorder, remains uncertain.

To elucidate klotho levels in adolescents with ADHD and to clarify its association with executive function.

The present study enrolled 92 adolescents (mean approximate age 14 years) diagnosed with ADHD and 80 age-matched healthy adolescents. All participants had their klotho levels measured and underwent the Wisconsin Card Sorting Test (WCST); their parents fulfilled the Swanson, Nolan and Pelham IV (SNAP-IV) scale and the Child Behavior Checklist-Dysregulation Profile (CBCL-DP).

Results from generalised linear models (GLMs), with adjustments for age, gender, body mass index, clinical symptoms (SNAP-IV and CBCL-DP scores) and ADHD medication use, indicated that adolescents with ADHD had significantly lower klotho levels (P = 0.044) and performed worse on WCST (P = 0.027) compared with healthy adolescents. The GLMs further indicated a negative association between klotho levels and the percentage of non-perseverative errors on WCST (P = 0.002).

Klotho may serve as a novel biomarker of ADHD and play a key role in ADHD-related executive dysfunction.

Depressive and anxiety disorders often co-occur with insomnia, creating complex treatment challenges. Although clinical guidelines recommend psychotherapy as first-line treatment for these comorbid conditions, limited access to psychological services in primary healthcare facilities in China often leads to heavy reliance on pharmacological therapy.

To the appropriateness of psychotropic medications for patients with insomnia comorbid with depressive or anxiety disorders at primary healthcare facilities in China.

This cross-sectional study included patients with documented diagnoses of insomnia comorbid depressive or anxiety disorders in 2022 at all 67 primary healthcare facilities in Dongcheng District, Beijing, China. The primary outcome was the prescribing rate of guideline-recommended psychotropic medications.

Among 842 patients with insomnia and depressive disorders and 1014 patients with insomnia and anxiety disorders, over 90% received psychotropic medications. Benzodiazepines were the most frequently prescribed classes (55.9 and 69.6%), followed by non-benzodiazepine hypnotics (42.5 and 42.4%), whereas medications recommended by the guideline, including antidepressants with sedative effects, selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors, were used infrequently. Only 29.9% of patients with insomnia and depressive disorders and 11.5% of those with insomnia and anxiety disorders received guideline-recommended pharmacotherapy, with lower concordance among older adults.

Guideline-recommended pharmacotherapy for insomnia comorbid with depressive or anxiety disorders was rarely implemented at primary care in China. This highlights the need to facilitate evidence-based practices and improve management of comorbid mental health conditions, particularly for older adults.

In 2018, the UK government commissioned National Health Service Talking Therapies (NHS TT) services to provide integrated mental and physical health care for individuals with a long-term condition (LTC) and coexisting depression and/or anxiety. Nevertheless, evidence on the effectiveness of NHS TT in physical LTCs remains inconsistent.

This review aims to evaluate the impact of NHS TT on mental health outcomes among adults with physical LTCs.

We conducted a systematic review and meta-analysis of quantitative studies published between 2008 and 2024. We used several databases for the search, including Embase, MEDLINE, Cochrane Library, NHS Evidence, PsycINFO, Bielefeld Academic Search Engine and ProQuest. We combined terms related to NHS TT, LTCs and mental health outcomes to identify eligible studies. The Population, Intervention, Comparison, Outcomes and Study framework guided the development of the inclusion criteria. We employed the random-effects model for meta-analysis and assessed heterogeneity bias using the I2 statistic, and the Newcastle–Ottawa scale to evaluate the overall quality of the evidence.

Twenty-four studies met the inclusion criteria. The meta-analysis revealed a significant pre–post NHS TT intervention effect on reliable improvement (odds ratio 0.77, 95% CI: 0.60–0.98) and reliable recovery (odds ratio 0.80, CI: 0.68–0.95). There were no significant differences in NHS TT accessibility (e.g. treatment engagement) between participants with and without LTCs (odds ratio 0.97, 95% CI: 0.82–1.14). However, heterogeneity between the studies was high (>90%).

The observed evidence provides reassurance for individuals with LTCs engaging with treatment; however, the association with post-treatment distress is still of concern. Furthermore, extensive and rigorous research is needed to strengthen and guide service development for individuals with LTCs, thereby improving effectiveness.

Suicidal ideation following trauma exposure is frequently associated with depressive and post-traumatic stress disorder (PTSD) symptoms; however, the interactive effects of depression and distinct PTSD symptom clusters on suicidal ideation remain poorly understood.

To examine whether specific PTSD symptom clusters – namely intrusion, avoidance and hyperarousal – moderate the association between depressive symptoms and suicidal ideation, and whether these effects vary across different trauma types.

Medical records of 127 psychiatric out-patients with a history of at least one traumatic event were analysed. All participants had completed the Hamilton Rating Scale for Depression, the Impact of Event Scale-Revised, and the suicidal ideation item of the Beck Depression Inventory II. Trauma types were categorised into early versus late, single versus multiple, and interpersonal versus non-interpersonal.

Hierarchical regression analyses identified a significant moderating effect of avoidance symptoms on the relationship between depression and suicidal ideation (β = 0.19, P = 0.012), whereas intrusion and hyperarousal symptoms did not show such effects. Specifically, higher levels of avoidance were associated with a stronger positive relationship between depression and suicidal ideation. This moderating effect was observed only among individuals with late (β = 0.28, P = 0.002), single (β = 0.29, P = 0.002) or non-interpersonal trauma (β = 0.34, P = 0.018); it was not evident among those with early, multiple or interpersonal trauma.

These findings underscore the relevance of targeting avoidance symptoms to mitigate suicidal ideation, particularly in individuals with late-onset, single-incident or non-interpersonal trauma exposure. Exposure-based therapeutic interventions may offer particular benefit for reducing suicidal ideation among trauma-exposed individuals with depressive symptoms.

Known influences on tic severity include medical, biological and contextual factors.

We aimed to further understanding of contextual factors by exploring if tic severity is influenced by calendar month.

This study used data from the Calgary Child Tic Registry. Children are extensively clinically phenotyped at their first visit and followed prospectively until adulthood. We evaluated the mean Yale Global Tic Severity Scale-Revised (YGTSS-R) total tic severity score based on the calendar month. Multivariable linear regression models were fit to assess the individual months adjusted for age, gender, comorbidity and tic treatment variables.

The study included 370 participants, with 549 assessments of tic severity performed. In the univariable analysis based on calendar month, August had the lowest tic severity, with a mean YGTSS-R total tic severity score of 15.68 (95% CI 13.41–17.95). This was significantly lower than the month with the highest tic severity, February, with a mean score of 20.41 (95% CI 18.19–22.63). In multivariable models adjusted for age, gender, comorbidity and treatment for tics, the omnibus test for whether month contributes to a better fit were not significant (YGTSS-R total tic score P-value: 0.495). The only significant predictors of increased tic severity were treatment for tics (P < 0.0001), diagnosis of depression (P = 0.003) and diagnosis of obsessive–compulsive disorder (P = 0.02).

While our univariate analysis of tic severity by calendar month supported significantly lower tic severity in August compared with February, this association was no longer statistically significant when controlling for other variables known to impact tic severity.

The COVID-19 pandemic caused by the SARS-CoV-2 virus was the biggest global health emergency in the past century. The impact of the pandemic on society, and demand for health services, especially mental health services is not fully understood.

We describe the change in activity in a single UK NHS mental health trust during and following the pandemic.

We conducted a retrospective service evaluation using a population-based referral rates and clinical activity for mental health disorders in Cambridgeshire over the period 1 January 2017 to 31 December 2023. We divided the time period into pre-pandemic period, during the pandemic, and post-pandemic months. A negative binomial regression model was fitted to the monthly rates to yield incidence rate ratios. Subgroup analyses were performed by age, gender, ethnicity, and level of deprivation.

There was a steep decline in both referrals and clinical contacts during the lockdowns with a subsequent and steep increase in these measures during the immediate post-pandemic period. Increased numbers of referrals and contacts have been sustained well into the post-pandemic period.

In a single county-wide mental health service in the UK, the prolonged and sustained increase in both referrals and activity post-pandemic was not matched by equal increase in resource to meet demand. Our findings may be useful to effectively plan mental health services before, during and after any future pandemics.

Perinatal obsessive–compulsive disorder (pOCD) is a common mental health difficulty. For some women with pOCD, a psychiatric in-patient admission is deemed necessary. In the UK, Mother and Baby Units (MBUs) are currently best practice for in-patient admission in the perinatal period. Wider OCD literature and pOCD case studies suggest the MBU environment may pose challenges to the treatment of pOCD.

To date, there has been no research exploring pOCD on MBUs, therefore, this study aimed to qualitatively explore women and professionals’ experiences of pOCD on MBUs.

Semi-structured interviews were conducted with eight women who self-identified as having experienced pOCD and an admission to an MBU, and ten professionals who had experience working with women with pOCD on MBUs. Interviews took place virtually and were recorded and transcribed. Reflexive thematic analysis was used to analyse the data.

Six themes were identified. (a) ‘MBU a last resort for OCD’, (b) ‘Developing a shared understanding of OCD’, (c) ‘A whole team approach to treatment’, (d) ‘Choice and control over exposure’, (e) ‘Ward as a safety net’ and (f) ‘Transitioning back to real life’.

The research highlighted a number of challenges in providing treatment for pOCD in this environment and suggestions are made for the development of clinical guidelines for supporting women with pOCD and designing specific training for MBU professionals.

The relationship between media portrayal of psychedelic drugs, scientific research and drug policy is an area of debate.

To apply artificial intelligence technology to measure trends in media sentiment towards the therapeutic potential of psychedelic drugs.

Up to 300 of the most relevant articles from Google News searches for the term ‘psychedelics’ were sampled for each year from 2000 to 2025. A large language model, ChatGPT, evaluated subject matter and sentiment.

In total, 88.3% of screened URLs (3308 of 3747) were included in the analysis. The proportion of articles focusing on the therapeutic potential of psychedelics increased from 13.3% (26 of 198) from 2000 to 2009 to 85.3% (1254 of 1470) from 2020 to 2025. The average sentiment score from 2000 to 2025 for articles from all publications (N = 2168) was 78.5 ± 9.3 (mean ± s.d.) (possible range: 1–100). 1.3% (29 of 2168) of articles carried negative sentiment (<50) whereas 4.8% (103 of 2168) had extremely positive sentiment (≥90). Average sentiment reached a peak in 2020 (80.8 ± 7.0), and a statistically significant trough in sentiment was observed in 2024 relative to 2020–2023 (2020–2023, 79.2; 2024, 74.3, P < 0.00001, Mann–Whitney U-test). The proportion of negative-neutral articles (≤65) increased annually from a trough of 3.6% (8 of 267) in 2020 to a peak of 20.9% (43 of 253) in 2024. Artificial intelligence sentiment scores were correlated and concordant with average human rater scores (r = 0.88, concordance correlation coefficient 0.84).

Although most 21st-century media coverage of psychedelic drugs has been positively framed, negative and neutral coverage has increased in frequency since 2020. Researchers, clinicians, regulators and policy-makers should be mindful of the complex relationship between media portrayals of psychedelics and the results of scientific research.

Entry to higher education coincides with a period of accelerated psychosocial and brain development. Student need for acceptable and accessible well-being and mental health support is straining university resources.

To evaluate the acceptability and impact of a digital mental health literacy course tailored for undergraduates and delivered as an accredited interdisciplinary elective.

Analyses included pre–post course survey data from enrolled students and longitudinal U-Flourish Well-Being Survey data from a comparison sample of non-course takers over the same period (2021–2024). Linear mixed-effects models examined associations between course participation and 12-week changes in mental health literacy, psychosocial risk factors, well-being and common mental health concerns.

Pre–post course survey data (N = 2884) supported high acceptability, improvements in resilience (+0.06; 95% CI 0.03–0.08, p < 0.001) and self-compassion (+0.65; 95% CI 0.46–0.84, p < 0.001), and a reduction in brooding (−0.31; 95% CI −0.44 to−0.18, p < 0.001). Taking the course was associated with a reduction in anxiety (β = −0.41; 95% CI −0.55 to −0.27, p < 0.001) and cannabis use (proportional odds ratio 0.82; 95% CI 0.75–0.90, p < 0.001), improvement in sleep quality (β = 0.79; 95% CI 0.61–0.97, p < 0.001) and evidence of a protective effect on well-being (β = 0.24; 95% CI 0.11–0.36, p < 0.001) and depressive symptoms (β = −0.37; 95% CI −0.52 to −0.21, p < 0.001), compared with non-course takers. Effects differed by gender, with women benefitting most, but were comparable across minoritised student subgroups.

Mental health literacy delivered as an accredited undergraduate interdisciplinary course is highly acceptable and associated with improvement in psychological coping and positive effects on student mental health and well-being. Future research should focus on more diverse student samples, underlying mechanisms and sustained effects.

Comorbid obsessive–compulsive disorder (OCD) or obsessive–compulsive symptoms (OCS) are common in people with severe mental illness (SMI; including schizophrenia, bipolar disorder and schizoaffective disorder), with little known about associations with smoking.

To estimate the association between OCD/OCS and smoking status among people with SMI in a huge electronic database.

Using the Clinical Records Interactive Search (CRIS) platform for data of service users in the South London and Maudsley (SLaM) NHS Foundation Trust, tobacco smoking status was retrospectively detected through an algorithm of natural language processing technique, categorising into ‘current smoker’, ‘ex-smoker’ and ‘non-smoker’ by the clinical notes of SMI individuals during 2007–2015. A hierarchical assignment rule was applied following the order of ‘smoker’, ‘ex-smoker’ and then ‘non-smoker’ in an individual. Logistic regression was used to examine the association between smoking and OCS in people with SMI for univariable and multivariable analyses.

We identified 15 479 SMI individuals (56% male; mean age 41 years old), with 90.4% ever smoked. Among them, 2320 (15%) had OCS (without OCD), while 2174 (14%) had a clinical diagnosis of comorbid OCD. After adjusting for demographics and functional status as confounders, both SMI individuals with OCS only and an OCD diagnosis were significantly more likely to have ever smoked (adj. odds ratio 1.47, 95% CI 1.23, 1.76 and adj. odds ratio 1.33, 95% CI 1.11, 1.60, respectively) compared with those without OCD/OCS.

In this large-scale analysis of people with SMI, we found that individuals with OCS or OCD were more likely to have ever smoked.

Major depressive disorder (MDD) is the leading cause of disability worldwide, affecting roughly 322 million people. Recently, doses of psilocybin have shown promise in treating mood disorders, sparking interest in other dosing practices. According to anecdotal reports and observational studies, microdosing psilocybin yields benefits to mental health; however, rigorously controlled trials have failed to produce compelling evidence for this.

To conduct a phase II, double-blind, placebo-controlled, randomised partial crossover trial to compare microdosing psilocybin to placebo for MDD, evaluating its safety, tolerability and preliminary antidepressant effects.

Forty adults with MDD will be randomised to four doses of psilocybin (2 mg) or placebo (maltodextrin) once weekly over 4 weeks, then four doses of psilocybin (2 mg) once weekly for an additional 4 weeks. The primary efficacy end-point will be change in depression symptoms, as measured at baseline (0 weeks), after the experimental phase (4 weeks), and after the open-label phase (8 weeks). A battery of mood, well-being, attention, creativity, mindfulness and pro-sociality measures will be administered at each time point. Follow-ups will occur every 6 months for up to 2 years after the trial start date, as part of a long-term extension study.

The results of the primary outcome of this trial will be published as a manuscript in a peer-reviewed science or medical journal regardless of the magnitude or direction of effect.

Findings will inform future research on microdosing psilocybin for MDD, regarding dose regimens, effect sizes and expectancy bias. Findings will also facilitate discussions on the comparable benefits of sub- versus threshold doses of psilocybin and the therapeutic value of radically altered perception.

ClinicalTrials.gov identifier: NCT05259943.

The effectiveness of electroconvulsive therapy (ECT) for depression strongly depends on patient characteristics. Clinical factors may increase (e.g. age, psychotic symptoms) or decrease (e.g. episode duration) response rates.

This prospective study aimed to develop an instrument for the prediction of ECT response in patients with unipolar depression.

N = 45 patients were assessed using the Göttingen Response to ECT Assessment Tool (GREAT; seven items, 0 to 14 points). Clinical outcome was measured using the Montgomery Åsberg Depression Rating Scale (MADRS). Response was defined as ≥ 50% MADRS-improvement or a clinical global impression improvement (CGI-I) score ≤ 2. Analyses were conducted between responders and non-responders.

Results showed a high correlation between GREAT-score and dichotomous response (r = 0.585) as well as MADRS-improvement (r = 0.554, both p < 0.001). Receiver operating characteristic (ROC)-analysis yielded an area under the curve (AUC) of 0.841 (asymptotic significance: p < 0.001). A cut-off point at ≥7 points predicted ECT response in individual cases with 80% accuracy. GLM-analyses showed a significantly better MADRS-improvement for patients with a GREAT-score ≥ 7 v. < 7 (interaction-effect: p < 0.001).

Our prospective study shows that an instrument consisting of seven clinical items is able to predict ECT response in depression with good accuracy. Limitations include a relatively small sample size and the lack of further potential predictors suggested by recent studies. GREAT will thus be modified to further improve its accuracy. Currently, it may give clinicians a relevant estimate of the likelihood and the extent of the individual response to ECT.

Mental health challenges are common in autistic individuals but there is limited research, particularly among preschool children.

To ascertain the nature and occurrence of mental health challenges in autistic preschool children, as well as their association with autistic traits and cognitive and adaptive functioning.

We conducted a secondary analysis of data collected from children attending Autism Specific Early Learning and Care Centres across six states in Australia. The primary outcome of mental health challenges was assessed using the Child Behaviour Checklist (CBCL). The severity of autism and autistic traits, such as social communication differences and repetitive behaviours, alongside cognitive and adaptive functioning, were used as exposure variables. Multivariable linear regression analyses examined the associations among mental health challenges, autistic traits, cognitive level and adaptive functioning, and adjusted for key sociodemographic covariates.

Among 760 children, about 76% scored above the clinical range of CBCL total problem scores. Mental health difficulties were significantly associated with greater severity of autistic traits, social communication differences and repetitive behaviours, and lower verbal developmental functioning and adaptive functioning. Additionally, sociodemographic determinants, such as children who were older, female or with an autistic sibling, were associated with higher risk of mental health difficulties, whereas culturally and linguistically diverse status, higher parental education and family income were protective against mental health challenges.

Our findings provide useful insights into the high prevalence of mental health difficulties among autistic preschool children, highlighting the significant association with autistic traits, cognitive and adaptive functioning levels and sociodemographic risk factors.

Although most couples share a bed, current interventions rarely consider dyadic sleep patterns.

We investigated whether bedtime alignment between partners affects longitudinal sleep outcomes in older couples, with particular attention to gender differences.

Based on the temporal relationship between partners’ bedtimes and the earlier sleeper’s sleep onset latency, 859 couples (1718 individuals) aged ≥60 years were classified into 5 mutually exclusive bedtime alignment groups. Pittsburgh Sleep Quality Index (PSQI) scores, sleep onset latency and sleep efficiency were compared using analysis of variance and multivariate analysis of covariance. Both cross-sectional and 8-year longitudinal trajectory analyses were conducted.

Bedtime alignment significantly affected sleep outcomes (P < 0.001, Pillai’s Trace = 0.37, F24, 3352 = 14.04, P < 0.001, η2P = 0.09). Couples with synchronised bedtimes demonstrated excellent sleep quality, whereas those with bedtime differences less than the earlier sleeper’s sleep onset latency exhibited the worst. The earlier sleepers in such couples experienced longer sleep onset latencies (53.4 ± 46.8 min) and greater sleep quality impairment (PSQI = 7.9 ± 4.1). The 8-year trajectory analysis revealed gender-specific vulnerability: only women in misaligned groups experienced progressive sleep deterioration over time (5.84 ± 8.42 min/year increase in sleep onset latency, P < 0.001; 1.27 ± 1.93%/year decrease in sleep efficiency, P < 0.001), whereas men maintained stable sleep parameters regardless of alignment.

Bedtime alignment represents a modifiable determinant of sleep health in older couples, with synchronised bedtimes providing optimal outcomes and partial sleep onset overlap creating disruption. This particularly benefits women, who show progressive deterioration with misalignment. These findings support the development of gender-informed, couple-based interventions for sleep disorders.