Family caregivers of terminal cancer patients often experience substantial emotional burden. This study assessed depression, anxiety, stress, and coping–distress associations among caregivers in Eastern India to inform culturally sensitive interventions.

A cross-sectional survey was conducted among 100 adult caregivers of terminal cancer patients at a tertiary care hospital in Kolkata. Participants were recruited via systematic random sampling and interviewed using a structured proforma, the 21-item Depression, Anxiety and Stress Scale (DASS-21) and the Brief-COPE inventory. Descriptive statistics summarized demographics and caregiving characteristics. Spearman’s rank correlation was used to assess associations between psychological distress and coping domains, with p < 0.05 considered statistically significant.

Caregivers (median age 43 years; 70% male) were predominantly the patient’s children (67%). Median DASS-21 scores indicated moderate depression (16), anxiety (14), and stress (16). Coping scores indicated low-to-moderate use of problem-focused (1.875 ± 0.321), emotional (1.871 ± 0.269), and avoidant coping (1.865 ± 0.266). Emotional coping correlated significantly with anxiety (ρ = 0.301, p = 0.002), depression (ρ = 0.317, p = 0.001), and stress (ρ = 0.293, p = 0.003). Depression also correlated with stress and problem-focused coping, while stress correlated with avoidant coping.

Caregivers experienced considerable psychological burden, with emotional coping consistently linked to distress. These associations likely reflect reactive adaptation rather than inherent maladaptiveness. Results highlight an urgent need to recognize caregiver distress within oncology settings and to develop culturally informed psychosocial interventions in palliative care, particularly in low-resource environments. Such efforts could enhance both caregiver well-being and quality of end-of-life care.

The World Health Organization (WHO) developed an assessment for healthy aging termed intrinsic capacity (IC). However, the association between IC and depression/anxiety remains poorly understood, with limited understanding of the underlying metabolic mechanisms.

This prospective cohort study comprised 212,033 UK Biobank participants recruited between 2006 and 2010. We calculated a UK Biobank-adapted four-domain IC deficit score using seven functional status indicators across psychological, sensory, vitality, and locomotor domains. Elastic net regression was employed to derive a metabolic signature that represented IC status. Polygenic risk scores (PRS) for depression and anxiety were computed from associated risk variants.

Compared with a 0 IC deficit score, participants with a 4+ score had higher risk, with hazard ratios (HRs) (95% CIs) of 3.96 (3.72–4.21) for depression and 3.03 (2.82–3.25) for anxiety. The metabolic signature of IC comprised 59 metabolites, with mediation effects of 1.007 (1.005, 1.008) for depression and 1.006 (1.004, 1.007) for anxiety. The highest hazards were observed in participants with high PRS and 4+ IC score; the HRs were 4.36 (3.70–5.13) for depression and 3.46 (2.87–4.17) for anxiety.

IC is associated with a higher risk of depression and anxiety, possibly mediated by its metabolic signature, with enhanced effects in genetically susceptible individuals.

This analysis aimed to examine past 20-year prevalence trends of multiple mental health outcomes by age and sex, using repeated cross-sectional survey data from the Canadian household population.

Age- and sex-stratified bootstrap-weighted prevalence estimates were calculated from available Canadian Community Health Survey datasets between 2002 and 2024. Categorizations for age included adolescents and young adults (12–29 years), middle-aged adults (30–64 years) and older adults (65+ years). Mental health outcomes included self-reported professionally diagnosed mood and anxiety disorder, depression survey scales (Composite International Diagnostic Interview Short Form for Major Depression /9-item brief Patient Health Questionnaire) and fair/poor self-perceived mental health. Stratified prevalence estimates from each year were combined and assessed for heterogeneity using random-effects meta-analysis. In the instance of heterogeneity, meta-regression models were applied to generate predicted prevalence trends over time for each mental health outcome, by age and sex categories.

The prevalence of all mental health outcomes increased from 2002/2003 to 2024, in all age groups of both sexes. For example, in adolescent and young adult males, the weighted prevalence of diagnosed mood disorder increased from 2.37% (95% confidence interval [CI]: 2.03, 2.78) in 2003 to 12.58% (95% CI: 10.37, 15.19) in 2024, while prevalence in females of this age group increased from 5.23% (95% CI: 4.76, 5.74) in 2003 to 21.49% (95% CI: 18.97, 24.24) in 2024. Generally, young males saw the greatest relative increases in prevalence, while young females had the greatest absolute increases. Middle-aged and older adults also saw notable increases in their prevalence of poor mental health. Quadratic survey year terms were statistically significant in meta-regression analysis for all outcomes, age and sex groups (excluding mood disorder trends in65+-year-old adults), suggesting curvilinear trends. Male age categories showed more similar trends over time when compared to age-specific estimates of females.

The broad identification of increasing prevalence across various outcomes, age and sex groups has not been highlighted by prior research. Though prevalence increases in young females remain distinct, this finding aligns with previous literature. Consistency of trend patterns between diverse mental health outcomes indicates that multiple dimensions of mental health may be changing similarly over time. Future analyses are critical in understanding the potential factors contributing to these trends and should look to include broad population samples, rather than limiting analyses to specific age/sex groups.

Recent studies indicate that anxiety is one of the most prevalent mental health challenges faced by children and adolescents diagnosed with autism spectrum disorder (ASD).

For young individuals with concurrent Intellectual disability disorder, these rates are projected to be significantly elevated.

Despite the estimated high prevalence of anxiety among young individuals with co-occurring ASD and intellectual developmental disorder (IDD), significant uncertainty remains in the field about the most effective methods for identifying, diagnosing, and treating anxiety in this distinct group.

The main objective of this narrative review is to examine the current literature on effective strategies and adjustments for evaluating and treating anxiety in children and adolescents who have co-occurring ASD and IDD, aiming to support professionals engaged with this significantly neglected group.

Prior research shows that humans adjust their learning rate based on environmental volatility. This adaptation has been shown to be reduced in individuals with high levels of anxious-depression, but past studies have been cross-sectional, making it unclear whether this adaptation is trait-like or responsive to treatment. There are also questions about the basic replicability of this effect with recent studies failing to find robust associations.

In the Precision in Psychiatry study, we examined changes in learning rate adaptation in a points-loss task, following four weeks of treatment in two patient groups receiving either internet-based cognitive behavioral therapy (n = 677) or antidepressants (n = 95), compared to a group of healthy participants (n = 95).

All groups showed increased learning rates in volatile environments at baseline, but against our prediction, learning rate adaptation was not cross-sectionally associated with individual differences in anxious-depression. There was also no evidence that learning rate adaptation changed post-treatment, despite symptom improvements. However, in the antidepressant group, symptom reductions correlated with learning rate adaptation. This finding should be interpreted cautiously as we found that the key outcome measure had poor test–retest reliability.

Overall, our results suggest that associations between learning rate adaptation and anxious-depression, if present, are likely modest, depend on task characteristics, may not be present in treatment-seeking adults, and do not improve following treatment.

This study aimed to examine the relationships between post-earthquake trauma, anxiety, stress, and stress coping strategies among university students who survived the Kahramanmaraş earthquakes.

This cross-sectional study included 384 university students who survived the Kahramanmaraş earthquakes. Data were collected using a personal information form and standardized scales assessing post-earthquake trauma, anxiety, stress, and stress coping strategies. Descriptive statistics, group comparisons, and correlation analyses were performed.

Among the participants, 35.7% had lost a relative, 47.8% had lost a friend, 10.0% reported that their homes were destroyed, 54.0% reported home damage, and 3.1% had been trapped under rubble. A strong positive correlation was found between post-earthquake trauma and anxiety scores (r = 0.714). Participants who had lost a family member, relative, or friend had significantly higher trauma and anxiety scores than those who had not. Trauma scores were also significantly higher among those who were injured, trapped under rubble, or involved in rescue efforts. Significant relationships were found between post-earthquake trauma, anxiety, stress, and stress coping strategies.

Earthquake-related experiences were associated with increased trauma, anxiety, and stress and with stress coping strategies. Early psychological assessment and psychosocial support may help reduce the psychological effects of earthquakes on university students.

Although a relationship between body fat and mental health problems has been established, sex-based differences in this association remain insufficiently understood.

To investigate the association of whole-body and regional fat mass indices with anxiety symptoms in men and women.

A nationwide sample of 3856 men and 5010 women was analysed. Fat mass of the whole body, trunk, arm and leg was measured using a bioelectrical impedance analyser, and fat mass indices (kg/m2) were derived by dividing fat mass by height squared. Symptoms of anxiety were determined using the Generalized Anxiety Disorder-7. Logistic regressions were used to investigate the association of each fat mass index with anxiety symptoms. Sex-stratified analyses were conducted to assess sex-related differences.

The prevalence of anxiety symptoms was 3.3% among men and 5.5% among women. Among female participants, a one-standard deviation increase in whole-body, trunk, arm or leg fat mass index was associated with 1.20-fold (95% CI: 1.04–1.39), 1.21-fold (95% CI: 1.04–1.41), 1.19-fold (95% CI: 1.04–1.35) and 1.19-fold (95% CI: 1.03–1.38) increases in odds of anxiety symptoms, respectively. By contrast, no clear association was observed between fat mass indices and anxiety symptoms in men.

Our analysis demonstrated sex differences in the relationship between body fat and anxiety, with high whole-body and regional fat mass indices positively associated with anxiety symptoms in women.

Reinforcement motivation, particularly heightened punishment sensitivity and its imbalance relative to reward sensitivity (“motivational bias”), can predict outcomes in anorexia nervosa (AN). However, previous studies did not account for affective symptoms, which are intertwined with reinforcement processes and illness trajectory. This study examined whether affective symptoms explain outcomes beyond reinforcement motivation.

Adolescent girls and young women with AN (n = 192; Mage = 16.33 years, SD = 2.61) completed self-report measures of punishment/reward sensitivity, depressive symptoms, and trait anxiety at treatment admission and at 1-year follow-up. Outcomes included ED symptoms, body mass index, and multidimensional recovery (Morgan–Russell outcome assessment schedule). Cross-sectional comparisons included long-term recovered individuals (n = 154) and healthy controls (n = 440); longitudinal associations were tested using nested linear regression.

Patients with AN and recovered individuals showed elevated punishment sensitivity (η2ₚ = 0.19) and stronger motivational bias (punishment>reward; η2ₚ = 0.17). At baseline, reinforcement motivation and affective symptoms showed limited predictive utility. Longitudinally, shifts in motivational bias were associated with ED symptoms and multidimensional outcomes (|β| > 0.248, pFDR < .002), whereas changes in affective symptoms were the most robust and consistently associated predictors (|β| > 0.173, pFDR < .017).

Depressive symptom improvement emerged as the key predictor of outcome, showing stronger associations with follow-up ED symptoms and psychosocial functioning than reinforcement motivation. While changes in reinforcement motivation accompanied ED outcomes, affective symptom change was more predictive across outcomes. These findings emphasize the importance of prioritizing affective processes within developmentally tailored AN treatment frameworks.

Survivors of the 1988 Halabja chemical attack have experienced severe, chronic trauma, yet limited research has examined the long-term psychological and biological consequences of chemical warfare exposure more than three decades later.

To examine long-term post-traumatic stress disorder (PTSD) symptoms, depression/anxiety symptoms, somatic symptoms and perceived stress among survivors of the Halabja chemical attack, and to investigate the associations of trauma exposure, sociodemographic factors and hair cortisol concentrations (HCCs) with psychological symptom severity and symptom profiles.

A total of 209 survivors of the Halabja chemical attack participated in structured interviews using culturally adapted and field-tested instruments, including the Post-Traumatic Stress Disorder Checklist for DSM-5, Hopkins Symptom Checklist-25, the Patient Health Questionnaire-13, the Perceived Stress Scale-14 and an adapted War and Adversity Exposure Checklist-26. Hair cortisol and cortisone concentrations were assessed as biomarkers of chronic stress. Data were analysed using correlations, independent-samples t-tests, multiple linear regression analyses, multinomial logistic regression and latent profile analysis (LPA).

Survivors demonstrated a substantial long-term psychological symptom burden. Overall, 87.6% of participants exceeded the cut-off for probable PTSD symptoms, and 75.1% exceeded the cut-off for elevated depression/anxiety symptoms. Most participants (81.8%) reported exposure to 11 or more lifetime traumatic events. Men reported significantly greater cumulative trauma exposure, whereas women reported significantly greater somatic symptom severity. Higher educational attainment and employment were consistently associated with lower psychological symptom severity across multiple outcomes. HCCs were not significantly associated with PTSD symptoms or latent symptom-profile membership after adjustment for trauma exposure and psychosocial variables. The LPA identified four symptom-severity classes characterised by differing levels of PTSD and depression/anxiety symptoms. Greater cumulative trauma exposure and lower social support were associated with membership in more severe symptom classes.

Survivors of the Halabja chemical attack continue to experience substantial psychological distress more than three decades after exposure. Long-term symptom severity appears to be more strongly associated with cumulative trauma exposure and psychosocial adversity than with HCCs. The findings highlight substantial heterogeneity in symptom presentation and support the need for long-term, culturally sensitive and trauma-informed mental health interventions for survivors of chemical warfare and mass violence.

To investigate the relationship between pain (including neuropathic pain [NP]), functional impairment, and anxiety/depression among Nigerian cancer patients.

This cross-sectional study enrolled 126 adult cancer patients at a Nigerian teaching hospital. Pain intensity, NP (painDETECT), functional impairment (Sheehan Disability Scale), and anxiety/depression (Hospital Anxiety and Depression Scale, HADS) were assessed.

Prevalence rates were 37.3% for anxiety and 35.7% for depression. Pain was reported by 82% of patients (predominantly mild), while NP occurred in 23%. Bivariate and correlation analyses showed no significant association between pain (including NP) and anxiety/depression (p > 0.05). However, functional impairment was strongly correlated with both outcomes (HADS-A: r = 0.470; HADS-D: r = 0.675; p < 0.001). Multivariate regression identified functional impairment as the strongest independent predictor of anxiety (odds ratio [OR] = 7.537) and depression (OR = 8.625). Pain intensity and NP were not retained as significant predictors.

Functional impairment, not pain nor NP, independently predicts anxiety and depression in Nigerian cancer patients. Routine functional screening may be more clinically useful than pain-focused assessments for identifying psychological distress in resource-limited oncology settings.

Over 1.6 million refugees and asylum seekers from Myanmar reside in neighbouring countries. These populations face substantial mental health challenges, yet existing evidence remains fragmented, making a comprehensive review essential.

To synthesise evidence on common mental disorders among Myanmar refugees, examine associated factors and explore challenges across host countries and refugee subgroups.

A systematic search of PubMed, PsycINFO, Web of Science, Embase, Scopus and grey literature was conducted through July 2025. Eligible studies reported on common mental disorders among Myanmar refugees of any age in regional host countries. Two reviewers independently screened studies and extracted data dually, assessed risk of bias with Joanna Briggs Institute checklists and synthesised findings narratively.

Of 1614 records, 14 studies met inclusion criteria, covering >10 800 refugees in Bangladesh (n = 9), Thailand (n = 3) and Malaysia (n = 2). Reported prevalence was high for depression (30.0–89.0%), anxiety (39.3–41.8%) and post-traumatic stress disorder (3.7–61.2%). Risk factors associated with poorer mental health included potentially traumatic events, female gender, older age, family dependency, post-migration difficulties, lack of social support, food insecurity and pre-existing health conditions. Employment and income were identified as protective factors. Mental health challenges varied by country. Barriers to care included limited service access, lack of culturally appropriate interventions and stigma.

Myanmar refugees experience a high burden of mental disorders shaped by both potentially traumatic events and post-migration stressors. Effective interventions should be context-specific, focusing on person-centred care tailored to the refugee experience, improved living conditions, strengthened social support and enhanced economic opportunities.

Depression and anxiety disorders and symptoms are among the leading causes of disability and global disease burden in young people. Scalable, unified interventions are required to address subthreshold emotional symptoms in adolescents as a preventive strategy. This study evaluated the effectiveness of a transdiagnostic treatment for adolescents with subthreshold emotional symptoms.

A multicenter, two-arm, randomized controlled trial was conducted. The Unified Protocol for Adolescents (UP-A) was compared with an active control consisting of protocolized progressive relaxation. A total of 676 adolescents (72.6% female; Mage = 13.77; SD = 1.39; range = 12–18 years) participated in the study. Primary outcomes were self-reported depressive and anxiety symptoms at postintervention, 6 months, and 12 months. The trial is registered with ClinicalTrials.gov (NCT05322642).

Three hundred seventy-eight participants were allocated to the UP-A group and 298 to the control group. Adherence was high in both conditions (≈78% attended >70% of sessions). Both interventions showed significant reductions in depressive and anxiety symptoms over time, with no significant between-group differences. At 12 months, the UP-A group showed marginally lower depressive symptoms and neuroticism. Significant treatment effects favoring the UP-A were observed for hyperactivity, conduct problems, and total mental health difficulties. Improvements were maintained across most outcomes at both follow-ups.

The comparable improvements observed across both conditions suggest that structured, group-based school interventions may help reduce emotional symptoms in adolescents with subthreshold presentations, rather than reflecting the superiority of a specific protocol. These findings support their potential for broad dissemination within stepped-care frameworks and for enhancing accessibility and real-world effectiveness of evidence-based treatments.