Loneliness is a global public health concern that has been widely associated with a variety of mental health impairments. Two dimensions of loneliness have been differentiated, that is, social loneliness (the perceived absence or inadequacy of a broader social network) and emotional loneliness (the perceived absence of a close, intimate relationship or emotional support from a significant person). The present study aimed to test the hypothesis that both dimensions of loneliness are differentially associated with mental health outcomes.

Altogether, 3275 individuals (aged 45.2 ± 15.7 years, 47.9% men), enrolled from the general population, were assessed at two waves spanning 6 to 7 months. Social and emotional loneliness were quantified using the 11-item De Jong Gierveld Loneliness Scale. Social isolation was assessed with the six-item Lubben Social Network Scale, depressive symptoms with the Patient Health Questionnaire-9, generalised anxiety with the Generalised Anxiety Disorder-7, social anxiety with the Social Interaction Anxiety Scale, and paranoid ideation with the Revised Green et al. Paranoid Thoughts Scale. The data were analysed using a cross-lagged panel network model. Covariates included age, gender, education, employment status, place of residence, monthly income, the history of psychiatric treatment and substance use.

Both dimensions of loneliness were bidirectionally associated and were found to have the highest overall weight of outcoming network connections. Emotional loneliness was bidirectionally and positively associated with all measures of mental health. In turn, social loneliness predicted higher levels of social anxiety but was not associated with other mental health outcomes. It was bidirectionally associated with social isolation.

The findings imply the relevance of differentiating social and emotional dimensions of loneliness in the assessment of its underlying mechanisms and consequences for mental health. Emotional loneliness might show a greater importance in the development of psychopathological symptoms compared to its social dimension.

Although often associated with ageing, disability is becoming increasingly prevalent among young adults. While disability can pose a substantial psychological burden for young adults on critical pathways to establish the foundations for their future, the mental health risks faced by this population remain underexplored.

This study aimed to (1) assess the association between disability – including its presence, severity and type – and the risk of depressive and anxiety disorders, and (2) examine whether this association varies across sociodemographic factors, health behaviours and comorbidities in a young adult population.

We conducted a population-based cohort study using linked data from the National Disability Registry and the National Health Insurance Database of South Korea. A total of 6,058,290 individuals aged 20–39 years who underwent health check-ups between 2009 and 2012 were followed through 2022. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for depressive and anxiety disorders.

Individuals with disabilities had significantly higher risks of depressive (aHR: 1.58, 95% CI: 1.55–1.60) and anxiety disorders (aHR: 1.50, 95% CI: 1.42–1.59). Increased risks were consistently observed across various disability types with the highest risk observed for mental health-related disabilities in depression (aHR: 4.98, 95% CI 4.62–5.37) and epilepsy-related disabilities in anxiety disorders (aHR: 12.05, 95% CI 8.73–16.63). Subgroup analyses revealed stronger associations among individuals in their 20s, low-income groups, non-smokers and those abstaining from alcohol, compared to their respective counterparts.

Young adults with disabilities, a population that has been relatively overlooked in policy discussions, warrant greater policy attention in relation to their mental health.

Exposure to workplace bullying is associated with an increased risk of mental health conditions, yet it is debated whether the association is causal. This study aims to address this by examining whether onset of workplace bullying is associated with initiating treatment with psychotropic medication, here used as a proxy measure for onset of common mental disorders.

We used two longitudinal datasets from Sweden and Denmark (mean age: 47.4, women: 52.8%), combined with national registry data on psychotropic medication purchases. Using a target trial approach, the study population (N = 25 309) consisted of employees free of workplace bullying and psychotropic medication use at baseline. We used Cox proportional hazards regression (adjusted for sociodemographic variables, depressive symptoms and psychosocial work characteristics) to assess the association between onset of exposure to workplace bullying and incident treatment with psychotropic medication during 2 years.

In total, 1490 individuals (5.9%) experienced onset of workplace bullying. Bullying onset was associated with incident treatment with any psychotropic medication (HR: 1.42, 95% CI 1.15–1.77, model adjusted for sociodemographic variables). This association was attenuated in the fully adjusted model (HR: 1.24, 95% CI 0.99–1.53). In analyses focusing on antidepressant treatment, the estimates were stronger (HR: 1.55, 95% CI: 1.15–2.09, fully adjusted model). The results further demonstrated an exposure–response relationship, such that higher frequency of bullying exposure was associated with an increased risk of initiating any psychotropic treatment and antidepressants.

Individuals experiencing onset of workplace bullying were at higher risk of starting antidepressant treatment within 2 years. This is the first study showing that onset of workplace bullying can contribute to the development of mental health conditions requiring medical treatment. These results underline the importance of preventive interventions that reduce workplace bullying.

The mental health risk factors for primary healthcare workers (PHWs) following the Coronavirus Disease 2019 pandemic and the differences by urbanicity remain unclear. In this study, we aimed to identify key factors of anxiety and depression among PHWs in urban and rural settings in China.

This cross-sectional study was conducted in all 31 provinces in mainland China, between 1 May and 31 October 2022. A total of 3,769 PHWs, including family physicians, nurses, public health professionals, pharmacists, and other medical staff, were recruited from 44 urban community health service centers and 27 rural township hospitals. The Bayesian Additive Regression Tree model was employed to identify risk factors of anxiety and depression.

Among 3,769 PHWs, 1,006 (26.7%) worked in urban areas and 2,763 (73.3%) in rural areas. Occupational satisfaction significantly influenced anxiety in both urban and rural practitioners. For urban PHWs, living with family (odds ratio (OR): 0.42, 95% confidence interval (CI): 0.28–0.62) and self-rated health (fair: OR: 0.31, 95% CI: 0.23–0.42; good: OR: 0.13, 95% CI: 0.09–0.20) were key factors of anxiety. For rural PHWs, after-work exercise (rarely: OR: 0.28, 95% CI: 0.11–0.76; frequently: OR: 0.15, 95% CI: 0.05–0.44) played a critical role. Depression was associated with after-work exercise, self-rated health, and occupational satisfaction for all PHWs. Additionally, living with family (OR: 0.51, 95% CI: 0.34–0.75) and organizational support satisfaction (satisfied: OR: 0.28, 95% CI: 0.19–0.42) were significant for urban practitioners.

Risk factors such as occupational satisfaction, health, and family relations significantly influence PHW mental health in China, with notable differences by urbanicity. Tailored mental health interventions are recommended to address urban–rural disparities.

While breast cancer is rare in men, its incidence is rising, prompting more research into the mental health impacts of the disease in male patients. Anxiety, depression and sleep disorders are well-documented in women with breast cancer, but the effects on men are not as well understood, underscoring a need for gender-specific analysis.

This retrospective cohort study used data from the Health Insurance Review & Assessment Service from 2009 to 2017, examining patients diagnosed with ductal carcinoma in situ or invasive breast cancer. A propensity score matching at a 5:1 ratio resulted in a sample size of 280 men and 1,400 women for analysis. The study assessed the cumulative incidence of anxiety, depression and sleep disorders, along with potential risk factors for these conditions.

Out of 75,936 breast cancer patients, 0.4% (281) were men. Women exhibited a significantly higher incidence of mental health conditions compared to men (p = 0.017), particularly in terms of anxiety. However, there were no significant gender differences in the incidence of depression or sleep disorders. Women demonstrated a higher risk of developing anxiety disorders (hazard ratio: 1.498, 95% CI: 1.057–2.123, p = 0.023). After adjusting for confounders, gender differences in depression and sleep disorders were not statistically significant.

Women with breast cancer experience higher rates of anxiety disorders, while depression and sleep disorders show no gender disparity. These findings suggest that mental health care approaches should be adapted to better support men with breast cancer and address their unique mental health needs.

To synthesize the available experimental study evidence to estimate the effects of ketamine on suicide ideation (SI) in high-risk individuals.

We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Double-blind randomized controlled trials and open-label studies investigating the safety and effectiveness of ketamine on SI published up to October 2025 were identified. Data were pooled using random-effects meta-analysis. The main outcome was standardized mean difference on SI in high-risk individuals. Secondary outcomes were the percentage of adverse events and the moderator effects.

We identified 21 studies with a total of 927 participants meeting our inclusion criteria. The pooled effect size for the reduction of SI after ketamine treatment was significant and clinically meaningful (large effect size of −1.40, 95% confidence interval: −2.15 to −0.66, P < 0.001, low–quality evidence). Dissociation (38.8%, P = 0.014), nausea (31.6%, P < 0.001), dizziness (24.7%, P = 0.003), headache (22.0%, P = 0.011) and anxiety (15.8%, P < 0.001) were the frequently reported adverse events. Moderator analyses indicated that the effect was higher in younger individuals and those with severe SI.

Our findings highlight the effectiveness of ketamine in reducing SI in high-risk individuals, especially younger individuals and those with severe ideation. Nonetheless, additional research is required to better understand optimal dosing regimens and the potential long-term effects of ketamine treatment.

Generalized anxiety disorder (GAD) is characterized by persistent worry and physical symptoms, with prevalence estimates ranging from 0.8% to 8%. Researchers utilize various tools, such as standardized diagnostic interviews and self-report questionnaires, to estimate GAD prevalence in population-level studies. However, the diagnostic accuracy of these tools varies greatly. This scoping review aimed to identify the tools used for GAD prevalence estimation and assess the extent to which diagnostic tool accuracy is reported.

A systematic search was conducted in MEDLINE, Embase and PsycINFO using MeSH terms and keywords related to GAD prevalence. No date restrictions were applied. Studies were eligible if they used nationally or regionally representative samples and defined GAD based on DSM-5, ICD-11 or older case definitions. Studies focusing solely on specific sub-groups were excluded. Data extraction included study characteristics, diagnostic tools and reporting of test accuracy.

A total of 537 studies were initially identified, with 48 meeting inclusion criteria, published between 1994 and 2024. Most studies were conducted in Europe (43.75%) and employed cross-sectional designs (92%). Structured diagnostic interviews were the most commonly used tool (77.08%), although self-report questionnaires gained popularity after 2005. Among the included studies, 62.5% reported test accuracy, often addressing validity and reliability.

Despite the widespread use of diagnostic tools in prevalence studies, test accuracy is not consistently reported, which may impact the reliability of prevalence estimates. The variability in agreement between self-report questionnaires and structured diagnostic interviews highlights the need for transparent reporting of test characteristics to improve the validity of GAD prevalence assessments across populations.

Reducing stigma and discrimination has been a priority in many national mental health policies for decades. Focusing efforts requires us to understand where this has the greatest impact on people with mental health problems. In 2024, we conducted a nationally representative survey that aimed to assess the burden of discrimination (as a product of frequency and impacts of experiences). Secondary aims were to quantify the types of discrimination experienced in different life domains and the sociodemographic and mental health problem characteristics of those experiencing higher burden.

Online surveys were completed by 6032 members of the general Australian community aged 18 years and over. The survey was carried out by the survey company The Social Research Centre, using their Life in Australia™ probability-based panel. Those who reported a mental health problem or scored high on the Kessler 6 measure of psychological distress (n = 2613) were asked about the past 12-month frequency and impact of their experiences of discrimination in a broad range of settings, including family, friends, workplaces and health services. The data were initially analysed using percent frequencies and 95% confidence intervals. A burden score was calculated for each domain, incorporating frequency and impact among those who reported discrimination experiences.

Overall, discrimination in social life was the most common (43.6% [95% CI 41.2, 45.9]), followed by discrimination from family (41.4% [95% CI 39.1, 43.7]) or in making or keeping friends (41.0% [95% CI 38.7, 43.3]). However, the highest burden was from discrimination in finding or keeping a job, in dating/intimate relationships, in housing (including renting or public housing) and in obtaining welfare benefits or disability pensions. The most common type of discrimination experience in the workplace and among friends, family and partners was of people lacking understanding of the impact of the person’s mental health problem. People aged 35–64 years were more likely than those aged 18–34 years to report higher burden in multiple domains; people with depression or attention-deficit/hyperactivity disorder also reported burden in more domains than people with anxiety or severe mental health conditions. Overall, 67.7% (95% CI 65.5, 69.9) agreed that stigma and discrimination was worse than the mental health problem itself.

Our study suggests that reducing the frequency and impact of discrimination in workplaces, welfare benefits and housing should be key targets for policy and practice. Improving the capacity of people in workplaces and intimate partners, families and friendship groups to better understand the impacts of mental health problems on individuals should also be a priority.

Off-label use of antipsychotics, often at low doses, is increasing. Exploring the link between individual antipsychotic treatment patterns, including low-dose continuous use, and cardiometabolic health is crucial to prevent long-term morbidity and mortality. The current retrospective study examined the prevalence of cardiometabolic medicine use among antipsychotic-users, and its association with their past antipsychotic treatment patterns.

Using a 10% sample of the Australian national medicine dispensing claims data from 2022, we identified individuals aged 15–64 years with ≥2 antipsychotic dispensings (antipsychotic-users) and non-users. We extracted their past 5-year antipsychotic treatment patterns (dose, duration and use of multiple agents). Using Poisson regression and accounting for age and sex, we calculated adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for cardiometabolic medicine use (anti-diabetics, antihypertensives, lipid modifiers, anti-thrombotics) among antipsychotic-users versus non-users. We applied unsupervised hierarchical clustering analysis to identify common antipsychotic-cardiometabolic co-dispensing.

Use of any cardiometabolic medicine was more prevalent among antipsychotic-users (35.8%, n = 28,345) than non-users (26%, n = 1,106,610) yielding an aPR of 1.30 (CI 1.28–1.33). aPRs for the use of anti-diabetics, lipid modifiers and antihypertensives were the highest among the younger age groups between 20 and 49 years and among women. Clustering analysis revealed increased co-dispensing of antipsychotics and anti-diabetics including sulfonylureas, statins, platelet aggregation inhibitors and beta blockers. The prevalence of cardiometabolic medicine use was associated with higher antipsychotic doses (23–54%), treatment duration (12–37%) and use of multiple agents (51%) compared with non-users. However, the prevalence of cardiometabolic medicine use for continuous (≥1 year) low-dose use of aripiprazole, asenapine, brexpiprazole, chlorpromazine, lurasidone, olanzapine, periciazine and quetiapine was also elevated (13–43%).

Use of cardiometabolic medicines is increased among people on long-term antipsychotic treatment. These results highlight the need for active monitoring for cardiometabolic adverse effects, with antipsychotic cessation where possible, or timely interventions to limit morbidity.

Assessing depression symptoms in people with a chronic illness is challenging due to possible bias from overlapping somatic symptoms associated with both depression and chronic illnesses. Previous studies, however, have found that people with a chronic illness do not report more somatic symptoms on depression measures than people without a chronic illness with similar levels of mood and cognitive symptoms. The reason for this surprising finding is unknown. Our primary objective was to evaluate differences in mean sum scores of Patient Health Questionnaire-8 (PHQ-8) somatic symptom items (sleep disturbances, fatigue, appetite changes) in people with a chronic illness when the items were administered outside the context of a depression questionnaire versus as part of the PHQ-8. Secondary objectives were to evaluate individual somatic item scores. We hypothesised that people who completed somatic items outside of a depression assessment would have significantly higher scores than those who completed items as part of a depression assessment.

We conducted a randomised controlled experiment within the Scleroderma Patient-centred Intervention Network (SPIN) Cohort, a multinational cohort of people with systemic sclerosis. SPIN Cohort participants were randomly allocated to complete the PHQ-8 with somatic items (sleep disturbances, fatigue, appetite changes) presented separately from psychological items and without any indication that they were part of a depression questionnaire (Reordered Items arm) or in standard format (Standard PHQ-8 arm). Participants were automatically randomised when they logged into the SPIN Cohort platform to complete routine research assessments. The primary outcome was the mean sum score of PHQ-8 somatic items. Secondary outcomes were the mean scores of individual somatic items. Differences were assessed using between-groups t-tests.

In total, 851 participants were included (N = 428 in Reordered Items arm, N = 423 in Standard PHQ-8 arm). Mean (SD) PHQ-8 score was 6.0 (5.3) for all participants. We found no statistically significant differences in PHQ-8 somatic item sum scores (0.05 points; 95% confidence interval [CI]: −0.29 to 0.38) or in mean scores for item 3 (sleep disturbances; 0.04 points; 95% CI: −0.09 to 0.19), item 4 (fatigue; 0.03 points; 95% CI: −0.11 to 0.16) and item 5 (appetite changes; −0.03 points; 95% CI: −0.15 to 0.10).

We did not find evidence that responses to PHQ-8 somatic items were influenced by whether participants were aware they were responding to items about depression. This finding supports the validity of self-reported questionnaires for depression symptom assessment in people with chronic medical conditions.

Post-traumatic stress disorder (PTSD) may shorten life expectancy, but evidence for Asian populations and cause-specific mortality remains limited. The aim of this study is to investigate the association between PTSD and mortality risk in an Asian population.

We used Taiwan’s National Health Insurance Research Database (2000–2022) to assemble a cohort of 28,777 individuals with incident PTSD and 115,108 age- and sex-matched unexposed individuals, plus a sibling cohort of 13,305 affected patients and 22,030 unaffected siblings. Cox models estimated adjusted hazard ratios (AHRs) for all-cause, unnatural-cause (suicide and accidents) and natural-cause mortality, with progressive adjustment for sociodemographic factors, comorbidity and familial confounding. Subgroup analyses addressed five psychiatric comorbidities, sex and age (youth, adulthood and older adults).

Over a mean follow-up of 8 years, PTSD was associated with excess all-cause mortality (AHR = 1.32, 95% CI 1.24–1.41) driven by markedly increased unnatural deaths (AHR = 5.93, 5.13–6.85), especially suicide (AHR = 10.36, 8.41–12.76) and accidental deaths (AHR = 2.18, 1.67–2.86). Natural-cause mortality showed no consistent increase (AHR = 0.91, 0.85–0.98). In sibling analyses, excess risks persisted for all-cause (AHR = 2.48, 2.04–3.01), unnatural deaths (AHR = 4.76, 3.58–6.34) and suicide mortality (AHR = 7.90, 5.21–11.97), but not for accidents or natural causes. The risk patterns were similar across different psychiatric comorbidity strata and genders; suicide and unnatural-cause excess remained evident in all age groups.

PTSD was associated with elevated premature death risk in Taiwan, primarily through suicide and unnatural causes. Integrating targeted suicide-prevention into PTSD care pathways may be essential to reducing this avoidable mortality burden.

Social anxiety disorder (SAD) is one of the most common anxiety disorders and is associated with significant impairment and societal costs. The association between SAD and mortality remains poorly understood, partly because in epidemiological research it is rarely studied independently from other anxiety disorders. In this population-based matched cohort and sibling control study, we estimated the risk of all-cause and cause-specific mortality in individuals with SAD.

From a population of individuals born from 1932 and living in Sweden between 1997 and 2020, we identified all cases of SAD (Swedish ICD-10 code F40.1) in the National Patient Register. Each of these individuals was matched on sex, birth year and county of residence with 10 individuals who had never received a diagnosis. Mortality data were extracted from the Cause of Death Register. Risks were estimated using Cox proportional hazards regression models. Models adjusted for sociodemographic covariates and other lifetime psychiatric disorders. We also identified all clusters of full siblings and conducted within-sibling comparisons to account for unmeasured familial confounding.

The matched cohort included 57,360 individuals with SAD and 573,600 unexposed individuals. During the follow-up, 2355 deaths were registered within the exposed cohort vs. 7800 deaths in the matched cohort (crude mortality rates, 5.25 and 1.73 per 1000 person-years, respectively). The full cohort was followed up for a mean of 7.87 years (standard deviation 5.23). In models adjusting for sociodemographic variables, individuals with SAD had a 2.24-fold increased hazard of all-cause mortality (95% confidence interval [CI], 2.13–2.35). The increased risk was observed for both natural (adjusted hazard ratio [HR], 1.62; 95% CI 1.52–1.72) and unnatural causes of death (HR, 4.18; 95% CI 3.82–4.58). The results were robust to additional adjustment for psychiatric comorbidities, but the magnitude of the associations was attenuated, particularly when adjusting for substance use disorders. In the sibling cohort, 39,993 individuals with SAD were compared with their 64,640 unaffected siblings. While the estimates were also attenuated, they remained statistically significant (HR for all-cause mortality, 1.40; 95% CI 1.36–1.45).

Individuals with SAD face an increased risk of mortality, attributable primarily to unnatural causes of death, such as suicide, but also to natural causes, even after adjusting for socioeconomic variables. Psychiatric comorbidities, particularly substance use disorders, and shared familial factors may also contribute to this excess death. Further study of underlying mechanisms may inform prevention and early intervention strategies to reduce mortality in this vulnerable population.

Existing reviews on mental health disparities between deaf and hard‐of‐hearing (DHH) and hearing populations have focused predominantly on children, adolescents, or older adults, leaving a gap for working-age adults. We conducted a systematic review comparing the prevalence, incidence, and severity of any DSM-5-TR or ICD-11 mental disorder between DHH and hearing adults aged 18–60 years. We aimed to quantify disparities and examine disorder-specific patterns to inform future research, policy, and service development.

On 13 December 2025, we searched Ovid Medline, Embase, APA PsycINFO and Web of Science. We included analytical observational studies involving DHH and hearing adults aged 18–60 years, reporting mental disorder prevalence, incidence, or severity. Two researchers independently extracted data, and risk of bias (RoB) was assessed using the modified CLARITY tool. We narratively synthesised findings by aggregating outcomes at the study level using two approaches: summary and majority of the effect directions within a study. Subgroup syntheses examined outcome type, study RoB, age group and mental disorder category.

Sixty studies (n = 8 578 466) met inclusion. In the summary-direction synthesis, 58.3% (35/60) of studies reported higher mental disorder outcomes for DHH adults, 21.7% (13/60) found no difference and 20.0% (12/60) had mixed findings; none indicated lower mental disorder outcomes for DHH. Under the majority-direction approach, 65.0% (39/60) showed higher mental disorder outcomes and 35.0% (21/60) no difference. These patterns were consistent across prevalence (62.8–72.1% higher) and severity (61.1% higher). Studies with higher RoB more often reported higher mental disorder outcomes (66.7–72.2%) than lower-RoB studies (54.8–61.9%), though both mirrored the overall synthesis. Effects were similar across younger (61.9–71.4%) and older adult samples (61.1–66.7% higher). Disorder-specific syntheses identified psychotic disorders, post-traumatic stress disorder and suicidal outcomes as having the strongest disparities (≥72.2% higher), followed by general mental disorders, anxiety and depression. Fewer than five studies examined each of the other disorders, thereby limiting conclusions for these disorders.

Most available evidence indicates that the prevalence and severity of mental disorders are higher among DHH adults aged 18–60 years than among hearing adults, with limited evidence on incidence. No studies reported lower aggregated mental disorder outcomes for DHH adults. Addressing these disparities requires targeted intervention research, supported by population-based, longitudinal and (quasi-)experimental studies including comprehensive reporting of participant characteristics. This will inform more tailored interventions, improve screening and ultimately contribute to better mental health and quality of life for DHH adults.

Intimate partner violence (IPV) victimization is associated with suicidal behaviour. Suicidal behaviour may also be raised among those who perpetrate IPV compared to those who do not; general population-based evidence is, however, lacking. We aimed to investigate the associations between using violence against an intimate partner with suicidal thoughts, suicide attempt and non-suicidal self-harm in the past year.

We analysed data from the 2014 Adult Psychiatric Morbidity Survey. Logistic regressions estimated associations between IPV perpetration and suicide attempt, suicidal ideation, and self-harm. Associations were estimated for men and women separately, and we explored interaction in estimates by IPV victimization.

After adjustment for demographic and socioeconomic covariates, lifetime IPV perpetration was strongly associated with past-year suicide attempt (men: odds ratio [OR] 3.6, 95% confidence interval 1.0–13.2, women: OR 4.2, 1.9–9.4), suicidal ideation (men: OR 2.7, 1.5–4.9, women: OR 2.6, 1.7–4.1) and self-harm (men: OR 4.9, 1.5–15.2, women: OR 3.3, 1.8–6.0). Estimates were substantially attenuated with adjustment for non-IPV life adversities, hazardous alcohol use, drug use and IPV victimization. Only the association with lifetime suicide attempt in women remained significant (OR 1.6, 1.1–2.3). Estimates were generally higher among those who had not experienced IPV victimization, although we found no evidence for interaction by IPV victimization on the association between IPV perpetration and suicidal behaviour.

There were greater odds of suicidality and self-harm among self-reported perpetrators of IPV compared to the general population. Many of these associations were accounted for by non-IPV life adversities, IPV victimization and substance use. Improving the identification and management of IPV perpetration, and developing targeted safety planning and interventions for this group could reduce suicide for perpetrators and victims of IPV.

Trauma-related psychopathology is markedly elevated among refugee populations, particularly those living in sustained displacement. While economic, social and psychological factors have been linked to the deterioration of mental health following trauma and displacement, these factors have rarely been investigated concurrently and longitudinally. Consequently, there is little information on the potential longitudinal mechanisms driving mental ill-health in displacement settings. This study explored the temporal association between economic stressors, social stressors, emotion dysregulation and psychopathology in 1,235 refugees displaced in Indonesia.

Refugee participants from Farsi, Dari, Arabic, Somali and English-speaking backgrounds completed an online survey at four timepoints, 6 months apart. Factors of interest were measured using validated instruments including the Patient Health Questionnaire (to assess depressive symptoms), Posttraumatic Diagnostic Scale (to assess posttraumatic stress [PTS] symptoms), Post-Migration Living Difficulties Checklist (to index economic and social stressors) and Difficulties in Emotion Regulation Scale (to assess emotion dysregulation).

Random-intercept cross-lagged panel analysis revealed that economic stressors and emotion dysregulation were central to the longitudinal course of trauma-related psychopathology. Specifically, economic stressors were associated with subsequent increases in PTS symptoms (B = 0.07, p = 0.047), depressive symptoms (B = 0.17, p < .001) and social stressors (B = 0.28, p < .001), while emotion dysregulation was antecedent to increases in PTS (B = 0.16, p < .001), depression symptoms (B = 0.13, p < .001), and social stressors (B = 0.10, p = .017). Additionally, depression was associated with subsequent increases in economic stressors (B = 0.18, p = .001) and social stressors were associated with subsequent increases in economic stressors (B = 0.12, p = .037).

The current study identified both economic stressors and emotion dysregulation as the main drivers of psychopathology for refugees. This indicates that both the structural barriers encountered in the environment and one’s internal capacity have a substantial impact on wellbeing. These findings highlight that alongside psychological interventions, policy changes that facilitate economic empowerment are critically, and equally, important.

This study aimed to assess the oral health status of individuals with schizophrenia and explore its association with behavioural and pharmacological factors, with particular focus on long-term antipsychotic treatment and cumulative anticholinergic burden.

A total of 153 adults with schizophrenia (18–65 years) from the Mental Health Network of Bizkaia (Spain), all under antipsychotic treatment for ≥12 months, were evaluated and compared with 153 controls from the general population. Data on socio-demographic variables, tobacco use and oral hygiene habits were collected. Oral health was assessed using the Decayed, Missing and Filled Teeth (DMFT) index and the Community Periodontal Index of Treatment Needs (CPITN). Unstimulated salivary flow was measured, and subjective xerostomia symptoms were recorded. Cumulative anticholinergic burden was estimated using the Drug Burden Index, considering both psychotropic and non-psychotropic medications. The association between dental health and clinical, behavioural and pharmacological variables was analysed in patients with schizophrenia.

Patients with schizophrenia exhibited significantly poorer oral health than controls, with higher mean DMFT scores (15.3 vs. 10.9; p < 0.001) and more advanced periodontal disease indicated by CPITN. Salivary hypofunction (<0.45 ml/min) was present in 31% of patients versus 12% of controls. In addition, high to very high anticholinergic burden was present in 71.9% of patients with schizophrenia, compared to only 3.3% of controls. In patients with schizophrenia, multivariate analyses identified the following as significant predictors of worse dental status (DMFT): age; smoking; female sex; illness duration; reduced salivary flow; poor tooth brushing; and anticholinergic burden. For periodontal health (CPITN), however, no variable was identified as a significant predictor of high-risk periodontal status.

Oral health is substantially compromised in individuals with schizophrenia, reflecting a multifactorial interplay of behavioural, systemic and pharmacological factors. Both cumulative anticholinergic burden and reduced salivary flow independently contribute to poorer dental health, while periodontal disease appears to result from more complex influences not fully captured with studied variables. These findings underscore the importance of proactive clinical strategies, including regular dental assessments, targeted oral hygiene interventions, interdisciplinary collaboration between mental health and dental care providers and careful review of psychopharmacological regimens to minimize unnecessary anticholinergic exposure. Such integrated approaches are essential to preserve oral health, enhance quality of life and improve long-term outcomes in this vulnerable population.

Limited studies have conducted a comprehensive investigation on the impact of China’s birth policy change on the mental health among women of childbearing age. This study aimed to explore the potential impact of China’s Universal two-child policy on depressive symptoms among women of childbearing age, based on national-representative, longitudinal survey data.

Data we employed in this study were derived from the China Family Panel Study (CFPS) for the waves of 2012, 2014, 2016, 2018 and 2020. We included 7481 currently married females (17079 for pooled sample) aged 20–40 years. Depressive symptoms were assessed using the Kessler 6 Rating Scale (K6) and the Center for Epidemiologic Studies Depression Scale (CES-D). All scores were standardized for analysis. We employ the difference-in-difference model to investigate the association between the implementation of the Universal Two-child Policy (UTP) and women’s depressive symptoms.

Women in the exposed group, after implementing UTP, had a standardized score of depressive symptoms 0.10 higher (95% CI: 0.03–0.16, p = 0.007) than during the pre-intervention period after controlling for multiple covariates. They also faced a higher risk of having moderate or severe depressive symptoms (OR = 1.45, 95% CI: 1.12–1.87, p = 0.004). The stratified analysis revealed that the negative impact of UTP on mental health was pronounced among women with advanced age, low education, medium family income, only male offspring before UTP, and no new birth after UTP.

We observed that the implementation of the UTP was associated with increased depressive symptoms among married women of childbearing age in China, with significant heterogeneity across different sociodemographic groups. Greater attention should be paid to the complex psychological conditions of women of childbearing age when adjusting fertility policies, which is crucial to prevent women from suffering poor mental health and to advance high-quality development in population health.

To examine mediators and modifiable psychosocial factors associated with psychological distress, depression, anxiety and self-rated health among Aboriginal and Torres Strait Islander peoples (hereafter respectfully referred to as ‘Indigenous Australians’) aged ≥18 years.

This was a cross-sectional study based on the analysis of the 2018–19 National Aboriginal and Torres Strait Islander Health Survey dataset (N = 3942). Odds ratios (OR) and 95% confidence intervals (CI) for associations and indirect effects for mediation analyses were computed.

Our results showed that Indigenous Australians with higher levels of perceived social support were less likely to have psychological distress (OR = 0.36, 95% CI: 0.23, 0.56), depression (OR = 0.44, 95% CI: 0.29, 0.67), anxiety (OR = 0.43, 95% CI: 0.28, 0.65) and low self-rated health (OR = 0.52, 95% CI: 0.33, 0.82). Similarly, those with a high level of mastery were less likely to have psychological distress (OR = 0.14, 95% CI: 0.11, 0.19), depression (OR = 0.20, 95% CI: 0.15, 0.28), anxiety (OR = 0.26, 95% CI: 0.20, 0.36), and low self-rated health (OR = 0.37, 95% CI: 0.28, 0.50). Perceived social support mediated 33.7% of the association between removal from the natural family and psychological distress, 14.6% of the association between discrimination and psychological distress, 20.3% of the association between discrimination and depression, 14.8% of the association between discrimination and anxiety and 16.6% of the association between discrimination and low self-rated health. Both perceived social support and mastery mediated the association between physical harm and psychological distress, depression and anxiety.

We believe that community-driven psychosocial programs that enhance social support, self-efficacy and cultural connection may significantly improve the mental health and psychosocial well-being of Indigenous Australians.

The development of psychopathology during childhood and adolescence is complex and likely to follow diverse patterns. Mapping trajectories of psychopathological difficulties may improve our understanding of the nature of emerging, resolving and persistent psychopathology. The purpose of this study is to examine trajectories of psychopathology throughout childhood and adolescence by examining multiple data sources, including questionnaire-based reports of emotional and behavioural difficulties, psychiatric diagnoses and prescribed psychotropic medications.

Group-based multi-trajectory modelling was used to identify the psychopathological trajectories. This study included 49,361 full-term live-born singleton children born between 1996 and 2003, recruited into the Danish National Birth Cohort. Strengths and Difficulties Questionnaire data were collected when the children/adolescents were 7, 11 and 18 years old. Annual information about psychiatric diagnoses and redeemed prescriptions for psychotropic medication was retrieved from nationwide registries between the ages of 1 and 18. We included six predefined dimensions to identify the trajectories: internalizing behavioural problems, externalizing behavioural problems, neurodevelopmental diagnoses, affective diagnoses, mixed psychiatric diagnoses and psychotropic medications.

Six distinct trajectory groups were identified for both boys and girls. Approximately 6% of the boys and 8% of the girls receive the bulk of the psychiatric diagnoses and psychotropic medications. We found no support for ‘pure’ internalizing or externalizing patterns in any identified trajectory, as problems in one dimension often indicated the presence of problems in another dimension.

Our results demonstrate substantial psychiatric comorbidity and add new insights to the understanding of child and adolescent well-being and the complex patterns of developmental psychopathology.