Around 140 million births occur worldwide annually. For some women, childbirth is traumatic and can lead to childbirth-related post-traumatic stress disorder (CB-PTSD), with adverse consequences for both women and their families. However, international evidence remains limited.

To estimate the international prevalence of traumatic birth and CB-PTSD.

The International Survey of Childbirth-Related Trauma (INTERSECT) is a cross-sectional survey conducted in 31 countries. Women were eligible if they were 6–12 weeks postpartum, legally adults and provided informed consent. Recruitment was through routine maternity services and data were collected from April 2021 to January 2024. Outcomes were assessed using the City Birth Trauma Scale. Traumatic birth was coded using DSM-5 criteria for a traumatic stressor, and CB-PTSD classified when all PTSD criteria were met. Dissociative subtype and differential diagnoses were also assessed.

A total of 11 302 women from 31 countries took part. Most participants were married, aged 30–34 years, with average household income and higher education, and 9.7% identified as being from ethnic or racial minority groups. The prevalence of traumatic birth and CB-PTSD varied across countries: traumatic birth ranged from 7 to 69% (mean 23.3, 95% CI 22.4–24.0), and CB-PTSD ranged from 1 to 36% (mean 6.7, 95% CI 3.7–9.7). CB-PTSD subtypes also varied: the dissociative subtype ranged from 1 to 24% (mean 3.8, 95% CI 2.1–5.4) and acute CB-PTSD from 0 to 7% (mean 1.3, 95% CI 0.7–1.9). Removal of participants with potential differential diagnoses did not affect prevalence rates in most countries. Many participants reported distress and impairment from symptoms, even when they did not meet CB-PTSD diagnostic criteria.

Results show that a notable proportion of women experience traumatic birth and CB-PTSD. The wide variation in prevalence suggests that cultural and healthcare factors unique to each country are important. Results emphasise the importance of routine trauma-informed assessment and culturally informed support in perinatal mental healthcare.

Mental health is a major public health concern. Over one in three people reported mental problems in 2023, and suicide is the second leading external cause of death. Manual coding of psychiatric diagnoses from free text into ICD-10 slows clinical workflows, introduces errors, and hinders research. Automating this process with natural language processing (NLP) and machine learning (ML) can improve consistency, reduce administrative burden, and assist clinicians in improving diagnostic accuracy and treatment planning.

1) to clean and normalize an anonymous corpus of 79,048 Spanish psychiatric notes; 2) to evaluate semantic representations and identify the most suitable Spanish biomedical embeddings; 3) to develop and compare multilabel classification models, including XGBoost, random forests, neural networks, hierarchical models, and large language models (LLMs) fine-tuned with QLoRA; 4) to measure performance and computational cost.

The dataset from a Spanish hospital was used for model training. It contained more than 150,000 diagnostic labels referring to 83 ICD-10 codes and was preprocessed to correct errors, normalize codes, and replace abbreviations. Several embedding models were tested, with multilingual e5-large selected as the most effective. This representation was used as input to classical classifiers, neural networks, hierarchical models grouped by diagnostic families, and LLMs. Training and evaluation followed a stratified split, using F1, precision, and recall as metrics. All experiments were executed on a single NVIDIA RTX 4090 GPU.

The best balance between accuracy and cost was achieved with multilingual e5-large embeddings and multilabel XGBoost, reaching F1 = 0.72 with four minutes of training (Figure 1). A neural network on top of the encoder increased F1 to 0.76, at 37× higher cost. The hierarchical family-based approach lowered combined performance to F1 = 0.667 due to error propagation, with overall results ranging from 0.37 (Disorders of adult personality and behaviour) to 0.78 (Mood disorder) across models. Llama-3 LLMs fine-tuned with QLoRA improved from near-zero performance to F1 = 0.62, showing potential but still underperforming compared to embedding-based models. All approaches were computationally feasible within limited resources.Image 1:

Automatic mapping of psychiatric notes to ICD-10 codes is feasible and clinically valuable. The embedding + XGBoost pipeline offers the most practical trade-off for immediate deployment, while fine-tuned encoders provide higher accuracy when computational budgets allow. Fine-tuned LLMs represent a promising medium-term option if larger corpora and hardware are available. Limitations include short note length, class imbalance, and labelling variability. Future work will explore active learning with experts, synthetic data generation, and adaptation to ICD-11.

None Declared

Highly processed food (HPF) consumption has been associated with increased risk of depression. However, the directionality of this relationship remains unclear. Understanding whether HPF consumption contributes to the development of depression, or if depression leads to greater intake of HPFs, is crucial for designing effective prevention strategies.

This study aims to examine the bidirectional association between HPF consumption and MDD in a sample of adults residing in Madrid and Barcelona. Specifically, it explores (1) whether higher levels of HPF intake are associated with greater odds of experiencing MDD, and (2) whether the presence of MDD is associated with higher HPF consumption.

We analyzed cross-sectional data from 1,378 adults participating in the Edad con Salud study, conducted in Madrid and Barcelona in 2023. HPF intake was assessed using the short-form Questionnaire for Highly Processed Food Consumption Frequency (sQ‑HPF) and categorized into tertiles (1 = low, 2 = medium, 3 = high). MDD during the past 12 months was assessed with the Composite International Diagnostic Interview (CIDI). Two weighted regression models were estimated: (1) a logistic regression assessing the association between HPF tertiles and 12-month MDD, and (2) an ordered logistic regression testing whether MDD predicts higher HPF consumption. Both models were adjusted for sex, marital status, age, education, and Functional Comorbidity Index (FCI).

Compared to participants in the lowest HPF consumption tertile, those in the medium tertile showed a non-significant trend toward higher odds of 12-month MDD (OR = 2.76; 95% CI: 0.85–8.95; p = 0.092), while those in the highest tertile had significantly increased odds (OR = 8.74; 95% CI: 3.00–25.53; p < 0.001). In the reverse model, participants with 12-month MDD had 4.39 times greater odds of being in a higher HPF consumption tertile (OR = 4.39; 95% CI: 2.22–8.68; p < 0.001).

Our findings reveal a strong bidirectional association between HPF consumption and MDD. Individuals with higher HPF intake are more likely to experience depression, and those with depression are more likely to report greater HPF consumption. These results highlight the need for integrated prevention strategies that address both dietary habits and mental health.

None Declared

The entorhinal cortex (EC) is the first cortical region affected by tau pathology in Alzheimer’s disease (AD), but its functions remain unclear. The EC is thought to support memory binding, which can be tested using the Visual Short-Term Memory Binding Test (VSTMBT). We aimed to test whether VSTMBT performance can identify individuals with preclinical AD before noticeable episodic memory impairment and whether these performances are related to amyloid (Aβ) pathology and/or EC tau burden.

Ninety-four participants underwent the VSTMBT (including a shape-only condition (SOC) and a shape-color binding condition (SCBC)), standard neuropsychological assessment including the Preclinical Alzheimer Cognitive Composite (PACC5), an Aβ status examination, a 3D-T1 MRI and a [18F]-MK-6240 tau-PET scan. Participants were classified as follows: 54 Aβ-negative cognitively normal (Aβ − CN), 22 Aβ-positive CN (Aβ + CN, preclinical AD), and 18 Aβ + individuals with Mild Cognitive Impairment (Aβ + MCI, prodromal AD).

Aβ + CN individuals performed worse than Aβ-CN participants in the SCBC while the SOC only distinguished Aβ − CN from MCI participants. The SCBC performance was predicted by tau burden in the EC after adjusting for Aβ, white matter hypointensities, inferior temporal cortex (ITC) tau burden, age, sex, and education. The SCBC was more sensitive than the PACC5 in identifying CN individuals with a positive tau-PET scan.

Impaired visual short-term memory binding performance was evident from the preclinical stage of sporadic AD and related to tau pathology in the EC, suggesting that SCBC performance could detect early tau pathology in the EC among CN individuals.

It remains unclear which individuals with subthreshold depression benefit most from psychological intervention, and what long-term effects this has on symptom deterioration, response and remission.

To synthesise psychological intervention benefits in adults with subthreshold depression up to 2 years, and explore participant-level effect-modifiers.

Randomised trials comparing psychological intervention with inactive control were identified via systematic search. Authors were contacted to obtain individual participant data (IPD), analysed using Bayesian one-stage meta-analysis. Treatment–covariate interactions were added to examine moderators. Hierarchical-additive models were used to explore treatment benefits conditional on baseline Patient Health Questionnaire 9 (PHQ-9) values.

IPD of 10 671 individuals (50 studies) could be included. We found significant effects on depressive symptom severity up to 12 months (standardised mean-difference [s.m.d.] = −0.48 to −0.27). Effects could not be ascertained up to 24 months (s.m.d. = −0.18). Similar findings emerged for 50% symptom reduction (relative risk = 1.27–2.79), reliable improvement (relative risk = 1.38–3.17), deterioration (relative risk = 0.67–0.54) and close-to-symptom-free status (relative risk = 1.41–2.80). Among participant-level moderators, only initial depression and anxiety severity were highly credible (P > 0.99). Predicted treatment benefits decreased with lower symptom severity but remained minimally important even for very mild symptoms (s.m.d. = −0.33 for PHQ-9 = 5).

Psychological intervention reduces the symptom burden in individuals with subthreshold depression up to 1 year, and protects against symptom deterioration. Benefits up to 2 years are less certain. We find strong support for intervention in subthreshold depression, particularly with PHQ-9 scores ≥ 10. For very mild symptoms, scalable treatments could be an attractive option.

To assess whether there is a change in the prevalence of depression and suicidal ideation after the strict lockdown measures due to the first wave of the COVID-19 pandemic in Spain, and to assess which are the factors associated with the incidence of a depressive episode or suicidal ideation during the lockdown.

Data from a longitudinal adult population-based cohort from Madrid and Barcelona were analysed (n = 1103). Face-to-face home-based (pre-pandemic) and telephone interviews were performed. Depression and suicidal ideation were assessed through an adaptation of the Composite International Diagnostic Interview (CIDI 3.0). Population prevalence estimates and multivariable logistic regressions were computed.

Prevalence rates of depression changed significantly from before to after the COVID-19 outbreak (from 3.06% to 12.00%; p = 0.01) and per sex and age groups. Individuals reporting COVID-19 concerns (odds ratio [OR] = 3.11; 95% confidence interval [CI] = 1.45–6.69) and those feeling loneliness (OR = 1.99; 95% CI = 1.52–2.61) during the lockdown were at increased risk of developing depression during the confinement. Resilience showed a protective effect against the risk of depression (OR = 0.57; 95% CI = 0.39–0.83), while individuals perceiving social support during the confinement were at lower risk of developing suicidal thoughts (OR = 0.21; 95% CI = 0.09–0.46). Greater disability during the lockdown was also associated with the risk of suicidal ideation (OR = 2.77; 95% CI = 1.53–5.03).

Continuous reinforcement of mental health preventive and intervening measures is of global importance, particularly among vulnerable groups who are experiencing the most distress. Future research should strive to evaluate the long-term effects of the COVID-19 crisis on mental health.

Electroconvulsive therapy (ECT) is an effective and safe medical procedure that mainly indicated for depression, but is also indicated for patients with other conditions. However, ECT is among the most stigmatized and controversial treatments in medicine. Our objective was to examine social media contents on Twitter related to ECT to identify and evaluate public views on the matter.

We collected Twitter posts in English and Spanish mentioning ECT between January 1, 2019 and October 31, 2020. Identified tweets were subject to a mixed method quantitative–qualitative content and sentiment analysis combining manual and semi-supervised natural language processing machine-learning analyses. Such analyses identified the distribution of tweets, their public interest (retweets and likes per tweet), and sentiment for the observed different categories of Twitter users and contents.

“Healthcare providers” users produced more tweets (25%) than “people with lived experience” and their “relatives” (including family members and close friends or acquaintances) (10% combined), and were the main publishers of “medical” content (mostly related to ECT’s main indications). However, more than half of the total tweets had “joke or trivializing” contents, and such had a higher like and retweet ratio. Among those tweets manifesting personal opinions on ECT, around 75% of them had a negative sentiment.

Mixed method analysis of social media contents on Twitter offers a novel perspective to examine public opinion on ECT, and our results show attitudes more negative than those reflected in studies using surveys and other traditional methods.

The pandemic caused by the coronavirus disease 2019 (COVID-19, SARS-CoV-2 virus) has infected more than 646 million people and caused more than 6.6 million deaths worldwide (December/2022). It is surprising that a virus that affects airways can trigger neurological manifestations. The aim of this study was to create and apply specific questionnaires/evaluations for post-COVID-19 patients to profile any neurofunctional sequelae.

Epidemiological and psychomotor aspects as well as the intensity of cognitive, memory, attention, and concentration impairment were assessed. A total of 184 subjects post-COVID-19 and a control group (n = 30) were evaluated.

The most prevalent blood types in the COVID-19 group were the same as those from control group and in Brazilian population (no influence). Loss of smell/taste and headache were the most common reported symptoms. Talking about psychomotor and neurofunctional aspects, COVID-19 induced marked impairments in the tests: fine motor development (diadochokinesis, puppets, fan, and knead paper); balance (immobility, static balance, feet in line, and persistence); episodic memory after distractors; verbal fluency; and clock, compared to the control group data. There was also marked increase of synkinesis. Therefore, COVID-19 induced impairments in psychomotor assessments and in different cognitive aspects of the Mini-Mental State Examination. These results are more surprising considering that most participants did not report pre-existing disease and did not require hospitalisation.

COVID-19 induced psychomotor, neurofunctional, and memory impairments, including in young and healthy subjects. The present study revealed neurological impairments, which should be considered in the development of rehabilitation protocols for patients affected by COVID-19.