Early prediction of depressive and anxiety disorders is challenging due to substantial heterogeneity in risk pathways. Conventional machine-learning models trained on aggregated populations may obscure subgroup-specific mechanisms and limit interpretability for prevention. We evaluated whether a hybrid unsupervised–supervised framework can identify meaningful subgroups and yield more interpretable risk prediction.

We analyzed cohort data of 15,897 Japanese adults who completed baseline (August–September 2020) and 6-month follow-up (February–March 2021) surveys and did not screen positive for depressive and anxiety disorders at baseline (K6 score < 13). Using 169 baseline demographic, psychosocial, lifestyle, and behavioral variables, we performed hierarchical clustering to derive data-driven subgroups. Within each cluster, we trained Random Forest models to predict incident screened depressive and anxiety disorders at follow-up (K6 ≥ 13) and interpreted predictors using SHapley Additive exPlanations (SHAP).

The overall 6-month incidence was 6.23%. A five-cluster solution revealed two high-risk subgroups: an older-adult profile with poor quality of life (12.9%) and a working-parent profile characterized by work–family overload (29.8%). Compared with a global model trained on the full sample, the cluster-then-predict framework showed broadly similar overall performance but performed better in the highest-risk subgroup and revealed more differentiated predictor profiles. Loneliness, health-related quality of life, happiness, and personality traits predominated in clusters with moderate adversity, whereas lifestyle disruption (sleep, diet, and irregular routines) characterized the high-risk late-life subgroup and alcohol dependence and work–family burden characterized the high-risk working-parent subgroup.

Addressing risk-factor heterogeneity before prediction may enable more interpretable, context-tailored prevention strategies.

The COVID-19 pandemic raised concerns about the mental health of an already burdened healthcare workforce. This study examined mental health trajectories among healthcare workers (HCWs) across the pandemic and identified personal and employment factors associated with different symptom patterns.

Longitudinal data were drawn from the NHS CHECK cohort, including clinical and non-clinical staff from 18 NHS Trusts in England (April 2020–April 2023). Growth curve and growth mixture models identified latent classes of HCWs characterized by distinct trajectories of probable common mental disorders. Secondary outcomes included anxiety, depression, alcohol misuse, and post-traumatic stress symptoms. Logistic regression examined associations between baseline personal and employment characteristics and class membership.

The analytical sample included 22,764 participants. For each outcome, growth mixture models identified two latent classes. Approximately 31% of HCWs experienced persistently high symptoms of probable common mental disorders, while 69% experienced persistently low symptoms. Similar patterns were observed for secondary outcomes, with small subgroups demonstrating worsening symptoms followed by improvement. Logistic regression analyses showed that being female, younger, single, working as a nurse, or having a pre-existing mental health diagnosis increased the odds of belonging to a high symptom class. Perceived support from colleagues and managers was protective.

While many HCWs reported consistently low mental health symptom levels, almost a third belonged to a latent class characterized by persistently high symptoms across all time points. These findings underscore the need for mental health support for vulnerable HCW groups, embedded within routine NHS practice rather than limited to crisis periods.

Patients hospitalized with a life-limiting illness, along with their loved ones, frequently experience anxiety, stress, and pain. Legacy building through storytelling and music may alleviate emotional strain and provide comfort. Musical Rounds is a novel music medicine program designed to reduce distress and support legacy building for adult patients receiving palliative care and their loved ones.

This multisite, mixed-methods, pre–post feasibility study was conducted across 3 hospitals in California, USA. Participants engaged in live bedside recording sessions in which personal stories were shared with real-time musical improvisation provided by a clinician-musician. Afterward, participants received a personalized edited recording combining voice and improvised music. Pain, stress, anxiety, and comfort were assessed before and after each session using a 0–10 numeric rating scale. Perceived mood changes were assessed through directed qualitative content analysis.

We invited 100 adult patients hospitalized with a life-limiting illness and their loved ones to participate. If patients were unable to respond, loved ones participated on their behalf. Patients (n = 79) demonstrated statistically significant within-group differences between pre- and post-session assessments, including lower pain (−1.58, p < .001), stress (−2.89, p < .001), and anxiety (−2.73, p < .001), and higher comfort (+1.61, p < .001). Loved ones (n = 42) reported lower stress (−3.14, p < .001) and anxiety (−2.86, p < .001), and higher comfort (+1.83, p = .004). Directed content analysis indicated perceived mood improvement in 59% (47/80) of patients and 68% (30/44) of loved ones.

Musical Rounds, a personalized music and storytelling session for hospitalized patients with life-limiting illness and their loved ones, was associated with lower self-reported stress, pain (patients only), and anxiety, and higher comfort and perceived mood across 3 hospitals. Findings demonstrate the feasibility and suggest potential benefits of music medicine–supported legacy building in palliative care. Controlled studies with independent assessors are needed to further evaluate efficacy.

The present study aimed to investigate the association between adherence to the DASH diet and the risk of depression and anxiety severity in a large group of Iranian adults.

In this cross-sectional study, dietary intakes were assessed using a validated 65-item food frequency questionnaire. The Beck Anxiety Inventory and the Beck Depression Inventory II were used to assess anxiety and depression, respectively. Ordinal logistic regression was applied to evaluate the association between DASH diet and depression and anxiety severity.

Mashhad stroke and heart atherosclerosis disorder (MASHAD) study.

6537 and 6539 adults aged 35-65 years for depression and anxiety, respectively.

We found no significant association between adherence to the DASH diet and depression severity, in the total participants as well as both gender in either crude (total: OR: 0.98; 95% CI: 0.87-1.09, men: OR: 0.88; 95% CI: 0.73-1.07, and women: OR: 1.01; 95% CI: 0.88-1.17) or fully adjusted models (total: OR: 1.03; 95% CI: 0.91-1.16, men: OR: 0.95; 95% CI: 0.78-1.17, and women: OR: 1.04; 95% CI: 0.90-1.21). Regarding anxiety, we found that men in the third tertile of DASH diet score had lower risk of experiencing more severe anxiety compared to those in the first tertile (OR: 0.80; 95% CI: 0.67-0.96). However, after controlling for potential confounders, this relationship became non-significant (OR: 0.89; 95% CI: 0.74-1.07). In the total participants as well as women, we failed to find any significant association between adherence to the DASH diet and anxiety severity either before (total: OR: 0.97; 95% CI: 0.87-1.09, women: OR: 1.05; 95% CI: 0.92-1.21) or after controlling for possible confounders (total: OR: 1.01; 95% CI: 0.90-1.12, women: OR: 1.06; 95% CI: 0.92-1.22).

We found no significant association between adherence to DASH diet and depression and anxiety severity among adults.

Clinically relevant anxiety can be detected in patients with amyotrophic lateral sclerosis (ALS), but its prevalence and determinants have not yet been fully assessed.

This study aimed at assessing the prevalence and clinical underpinnings of anxiety in ALS.

Non-demented ALS patients (N = 433) and healthy controls (N = 313) were administered the State- and Trait-Anxiety Inventory – Form Y (STAI-Y1 for state-anxiety and STAI-Y2 for trait-anxiety) and the Beck Depression Inventory (BDI). Patients were further assessed for cognition (Edinburgh Cognitive and Behavioural ALS Screen), behaviour (Frontal Behavioural Inventory) and motor status (disease duration, ALS Functional Rating Scale-Revised and progression rate). The prevalence of clinically significant state- and trait-anxiety were estimated by applying age-stratified cut-offs to STAI-Y1/-Y2 t-scores. Linear and logistic regressions were run to test the determinants of STAI-Y1/-Y2 scores.

STAI-Y1 and -Y2 scores above cut-off were detected in 18.2 and 13.9% of patients, respectively – with proportions being higher in cases versus controls (ps < 0.001). BDI, but neither cognitive/behavioural nor motor variables, was identified as a significant predictor of STAI-Y1/-Y2 scores (ps < 0.003). The cognitive–affective subscale of BDI was the sole predictor of scores above cut-off on both STAI-Y1 and STAI-Y2 (ps < 0.001).

Clinically significant levels of state- and trait-anxiety occur in ∼18 and ∼14% of non-demented ALS patients, respectively, mostly driven by cognitive and affective facets of depression, and are independent of motor and cognitive/behavioural features.

Anxiety disorders are prevalent neuropsychiatric conditions associated with neuroinflammation and altered cytokine signalling in the hippocampus. This study aimed to evaluate the anxiolytic-like effects of alpha-pinene and its potential modulation of hippocampal neuroinflammatory pathways in a reserpine-induced anxiety model.

Adult male Wistar rats were randomly assigned to four groups: control (vehicle), reserpine (0.5 mg/kg, i.p.), and reserpine co-treated with alpha-pinene at 50 or 100 mg/kg. Treatments were administered intraperitoneally for 10 consecutive days. Behavioural assays – including the Open Field Test, Elevated Plus Maze, and Light/Dark Box Test – assessed locomotor activity and anxiety-like behaviours. Following testing, hippocampal tissues were collected for molecular analyses, including real-time PCR for TLR4, MyD88, and NF-κB expression, and ELISA quantification of IL-1β and IL-6 levels.

Reserpine induced robust anxiety-like behaviours, accompanied by significant upregulation of TLR4, MyD88, and NF-κB expression and increased hippocampal IL-1β and IL-6. Alpha-pinene treatment at both doses significantly attenuated anxiety-like behaviours and reduced neuroinflammatory markers, suggesting involvement of the TLR4/MyD88/NF-κB pathway.

Alpha-pinene exhibits anxiolytic-like effects in reserpine-treated rats, potentially via suppression of hippocampal neuroinflammation, supporting further investigation into its therapeutic potential for anxiety disorders.

The Generalized Anxiety Disorder 7-Item Scale (GAD-7) is a brief self-reported measure for screening for anxiety symptoms. However, the evidence about its cross-cultural validity is fragmentary and usually focused on specific settings. Therefore, we aimed to critically review and synthesize the existing evidence about the cross-cultural validity of the GAD-7.

We conducted a systematic review of studies assessing the cross-cultural validity of the GAD-7 in following the PRISMA guidelines. Additionally, the quality of the studies was assessed following the COSMIN guidelines, and the quality of the evidence was assessed with the GRADE. Data were synthesized narratively.

Out of 1,965 unique records, 9 unique studies were deemed eligible for the COSMIN appraisal and the narrative synthesis (total sample: 11,894, 53.7% females and 20 different cultural groups). Most studies (7) had adequate quality and showed evidenced of the unitary structure of the GAD-7 across cultural groups. In 4 studies also assessing possible cultural bias, the effect on the general score was deemed negligible.

The evidence about the cross-cultural validity of the GAD-7 is very limited. Although more research is needed, the evidence available shows that the GAD-7 could be a cross-culturally valid tool for the assessment of anxiety symptoms in clinical contexts and epidemiological studies. Until new high-quality evidence will be available, these results would constitute a key first step for supporting the use of the GAD-7 in multi-cultural clinical settings and to inform clinical, public health and global health decision making in relation to anxiety.

Providing care for children with life-limiting conditions(LLCs) is an emotionally challenging experience that often exposes caregivers, particularly mothers, to considerable risk of psychological distress. The purpose of this study was to examine the moderating effect of emotional dysregulation on the relationship between severity of anxiety and depressive symptoms and high caregiving intensity, controlling for sociodemographic characteristics among mothers caring for children diagnosed with life-limiting conditions.

Using a cross-sectional descriptive design, a convenience sample of 192 mothers caring for children with life-limiting conditions was recruited and filled out an online self-administered questionnaire. Data were collected using online self-administered questionnaires regarding the sociodemographic characteristics of mothers and their children, emotional regulation difficulties (DERS), and the levels of anxiety and depressive symptoms among the mothers (DASS-21).

The analysis showed that 21.4% and 7.8% of mothers had moderate and severe depressive symptoms, and 19.3% and 15.6% had moderate and severe anxiety symptoms, respectively. The analysis also showed that emotional dysregulation is associated with high levels of anxiety (β = 0.74, P < 0.001) and depression (β = 0.74, P < 0.001); however, there was no significant moderating effect.

Anxiety and depression are significant psychological distress among mothers caring for children with life-limiting conditions and can be aggravated by emotional dysregulation and caregiving burden. There is a need to integrate interdisciplinary teamwork and family-centered care to provide holistic care and offer early screening, detection, and emotional regulation-focused management programs for psychological distress at healthcare services that care for children with LLCs.

The Family Adaptation study, ancillary to the Single Ventricle Reconstruction Trial, examined the prevalence of anxiety and its associations with stress, psychosocial factors, and quality of life measures in parents of infants who underwent the Norwood procedure.

Two hundred and fifteen parents (143 mothers and 72 fathers) of 146 infants completed state anxiety (State Anxiety Inventory), stress, psychosocial, and quality of life measures post-Norwood, post-Stage II, and at a final visit (median child age: 14 months).

A substantial proportion of parents reported severe anxiety symptoms following the Norwood surgery, with 61% of mothers and 43% of fathers affected, decreasing over time to 46% and 33% by the final visit, respectively. Mothers’ average STAI-S scores were significantly higher than fathers’ post-Norwood (47.7 ± 13.2 versus 43.5 ± 11.8, p = 0.03), declining to 42.1 ± 13.0 versus 39.0 ± 9.6 (p = 0.14) at the final visit. Stress related to parenting a child with a serious illness was a stronger and more consistent predictor of mothers’ anxiety over time (highest R2 = 0.49 for emotional distress), whereas insufficient coping and fewer protective factors were greater and more consistent predictors for fathers (highest R2 = 0.40 for mastery and health). Quality of life was a consistent predictor of state anxiety for both mothers and fathers.

Anxiety is elevated in parents of infants who underwent the Norwood procedure and is influenced by a complex interplay of stress, psychosocial factors, and quality of life. Addressing these factors is crucial for improving parents’ mental health, which in turn promotes the well-being of the entire family.