This study aimed to examine the association between protein intake and risk of sarcopenia, with a specific focus on protein sources, in middle-aged and older adults.

This was a 9-year follow-up study. Dietary protein intake was assessed by a validated food frequency questionnaire with energy adjustment using the residual method. Sarcopenia was defined by using height-adjusted appendicular lean mass and grip strength. Adjusted odds ratios (ORs) for sarcopenia were calculated by multivariable logistic regression analysis.

Baseline surveys (2011–2014) for the Murakami and Uonuma cohorts assessed body size, lifestyle, and medical history. Sarcopenia-related measurements were conducted in 2021–2022 in Murakami, Sekikawa, Uonuma, and Minamiuonuma, Japan.

6,232 individuals aged 40–74 years (mean age, 62.4 years; females, 54.8%).

Higher plant protein intake was associated with lower odds of sarcopenia, especially in males (P for trend=0.018), although total and animal protein intakes were not. Animal-to-plant protein ratio was U-shaped in its association with sarcopenia; adjusted ORs for the lowest and highest quintiles of the ratio compared to the middle quintile were 1.71 (95%CI: 0.96–3.07) and 1.97 (95%CI: 1.10–3.53), respectively, for males (P for quadratic term=0.017), and 1.93 (95%CI: 1.06–3.51) and 1.65 (95%CI: 0.90–3.05), respectively, for females (P for quadratic term=0.010).

An imbalanced intake of plant and animal proteins may increase the risk of sarcopenia, highlighting the importance of balanced protein intake.

Psychotic-like experiences (PLEs) are common in adolescence and often associated with later mental health difficulties. Although many psychosocial factors are related to PLEs, little is known about how these factors interact over time. Longitudinal network analysis allows examination of the stability of symptom associations and identification of potential intervention targets. This study investigated the structure and temporal stability of PLE networks in a large community-based adolescent cohort.

Adolescents aged 13–19 years (N = 605 with complete data across all time points) completed assessments at baseline, 12 months, and 24 months. Measures included positive and negative PLEs, cognitive biases, depression, anxiety, trauma, and interpersonal sensitivity. Networks were estimated at each time point, and permutation-based tests were used to compare network structure and overall connectivity across time. Centrality stability was assessed using bootstrapping procedures.

Network structures were stable across the 2-year period, with no significant differences in overall organization or connectivity between time points. Depression consistently showed the highest centrality, followed by anxiety and attributional bias. Positive PLEs were most strongly associated with anxiety, while negative PLEs showed their strongest associations with depression. Attributional bias remained centrally positioned and was strongly linked to trauma. All networks showed robust accuracy and high stability.

Despite considerable developmental change during adolescence, the psychosocial architecture of PLEs remained notably stable. Depression, anxiety, and attributional biases emerged as consistent key nodes, highlighting them as promising targets for prevention and early intervention in adolescents at risk for persistent PLEs.

Depression is often accompanied by multisystem comorbidities, but the time trajectories of these comorbidities remain unclear.

We aimed to define the temporal sequence of comorbidity accrual relative to depression diagnosis, and examine how this trajectory differs in recurrent depression.

A total of 32 953 individuals with depression were identified in the UK Biobank cohort, including 2402 with recurrent depression. The time between diagnosis of depression or recurrent depression and ten common comorbidities was established to determine the temporal order and rate of comorbidity diagnosis in relation to depression, based on the sequence of recorded diagnostic events. We further stratified the cohort by polygenic risk score, gender, age and history of antidepressant or antihypertensive medication use.

The study included 32 953 participants (mean age at diagnosis 52.6 years; 63.1% female). Hypertension and dorsopathies preceded depression diagnosis by a median of 2.6 years (interquartile range (IQR) −7.0 to 0.0) and 1.0 year (IQR −5.0 to 2.0), respectively. Alzheimer’s disease and obesity emerged after diagnosis at medians of 2.5 years (IQR 0.0–5.0) and 0.8 years (IQR −2.0 to 3.0). High genetic risk was associated with an earlier onset of pre-depression cardiometabolic conditions, with hypertension occurring 2.8 years before diagnosis in individuals with a high polygenic risk score compared with 2.3 years in individuals with a low polygenic risk score. Crucially, individuals with recurrent depression exhibited a profoundly different trajectory, with most comorbidities manifesting many years after the index diagnosis. Stratification by medication history indicated that antihypertensive drug use was associated with an earlier recorded diagnosis of cardiometabolic conditions, whereas antidepressant use was linked to a later diagnosis of neurodegenerative diseases.

These findings identify three critical windows for intervention and reveal a distinct, delayed comorbidity trajectory in recurrent depression. This underscores the need for long-term, integrated surveillance strategies tailored to depression subtype and treatment history.

Chronotype reflects individual variation in circadian rhythm (CR) (e.g., morningness versus eveningness). CR and chronotype have been associated with dementia pathology, and recent literature suggests that impaired sleep quality and CR disturbances may represent relevant causal factors for dementia. Current evidence is scarce and consists of just a small number of cross-sectional analyses and one longitudinal study. The aim of this study is to investigate the longitudinal association between chronotype and dementia risk in the older adult population, aged 60 years and older.

Linking data from the Lifelines Cohort Study and data from Vektis obtained by Statistics Netherlands led to a sample for analysis of n = 16,757 participants. Chronotype was measured with the Munich ChronoType Questionnaire (MCTQ) between 2011 and 2015. Chronotype was categorised into five categories: extremely early, slightly early, intermediate, slightly late, extremely late. Dementia incidence was based on having at least one dementia indicator from the Vektis dataset in the years 2018 until 2024. A discrete-time survival model was used to examine the association between chronotype and dementia. Age was specified as the underlying time scale in the discrete-time logistic survival analysis. Sex was included as a covariate. Interactions between age, sex, and educational attainment and chronotype were measured by including relevant interaction terms in the model.

The median age in the sample was 65 years old, and 54% was female. In total, 7% got dementia during a mean follow-up period of 6.6 years. Most individuals had an intermediate chronotype (56%), with about 20% of the individuals having a slightly early and late chronotype, and only about 3% having an extremely early and late chronotype. Individuals with a slightly early (HR, 1.26 [95% CI: 1.08, 1.46]) and an extremely late chronotype (HR, 1.42 [95% CI: 1.00, 2.02]) had an elevated risk of dementia. There were no significant interactions.

Having a slightly early as well as an extremely late chronotype was associated with an elevated risk of dementia.

Cohort studies of individuals with a suicide attempt are crucial for identifying risk and protective factors to prevent recurrence. The SURVIVE prospective cohort study aims to investigate the demographic and clinical profiles of individuals presenting with suicidal behaviour.

A total of 1,741 individuals (289 adolescents aged 12–17 and 1,443 adults aged 18 and older) were recruited from emergency departments at eight hospitals across five Spanish regions following a suicide attempt. Baseline data were collected using structured clinical interviews and validated self-report instruments. Sociodemographic and psychiatric variables were analysed.

Most participants were female, and approximately 20% were migrants. Religious affiliation was reported by 35.6% of adolescents and 48.4% of adults. Depression and anxiety were the most prevalent psychiatric diagnoses, while trauma-related and eating disorders were more frequent in adolescents, and substance use disorders in adults. Non-suicidal self-injury was reported by 76.6% of adolescents and 40.1% of adults. The most common method of attempt was self-poisoning in both groups. Psychotropic medication use was widespread, with both groups receiving a similar number of prescriptions.

The SURVIVE study provides a detailed characterization of suicide attempters in Spain, highlighting age-specific clinical patterns and contextual risk factors such as migration and religion. These findings underscore the need for tailored prevention strategies that consider developmental stage, psychiatric comorbidity, and social vulnerability.

Postinfectious autoimmune processes are hypothesized to be causally implicated in tic disorders, including Tourette syndrome and chronic tic disorder. However, this hypothesis remains controversial. In this nationwide cohort study, we aimed to clarify the mechanisms underlying the association between proneness to infections and tic disorders.

Using Swedish national registers, we identified 3,886,533 individuals (probands) born between 1970 and 2008 with available data on both biological parents. Probands were linked to six clusters of relatives: parents, full siblings, maternal half-siblings, paternal half-siblings, aunts/uncles, and cousins. Cox proportional hazards regression models were used to estimate the risk of tic disorders in probands exposed to infections and their relatives, compared with unexposed probands and their relatives. We also examined dose–response associations using logistic regression models.

Probands exposed to infections had an increased risk of tic disorders (hazard ratio [HR], 1.46; 95% confidence interval [CI], 1.40–1.52), as did their relatives. The observed risks increased with the degree of genetic relatedness, from HR (95% CI) of 1.15 (1.12–1.19) in cousins to 1.31 (1.25–1.37) in first-degree relatives. There was a dose–response association between the number of infections in the probands and the odds for tic disorders in the probands and their relatives. Results remained consistent after adjustment for infections in relatives, tic disorders in probands, and autoimmune diseases in probands and relatives.

Our results suggest an important role of shared genetic factors in the association between infections and tic disorders, potentially pointing to pleiotropic mechanisms.

In the Netherlands, around 750 children (0–21 year) die annually from potentially palliative conditions. The majority of these children reside at home, receiving care from hospital services and primary care. This study aims to examine general practice utilization for pediatric palliative care patients in the last 2 years of life.

A retrospective cohort study was performed using the routine healthcare database of the Julius General Practitioners’ Network. The main outcome for general practitioner (GP) utilization was the number of GP consultations for children in the last 3 months of life. Participants were included who were children (0–21 years), and deceased in the period 01-01-2013 to 31-12-2022 from an underlying chronic condition. Data were analyzed using descriptive statistics and tested for differences in provided care between children who died in hospital and who died at home.

Forty-eight children from 32 GP practices met inclusion criteria. Median age was 10.0 years (interquartile range [IQR] 1.5–17.1). Common diagnoses were oncological (29%), congenital (29%), and metabolic conditions (23%). Ninety-six percent of children had contact with their GP in the last 3 months (median 7 consultations, IQR 3.0–10.0), i.e. 26 children who died in hospital had median 3.5 GP consultations compared to 20 children who died at home median 9.5 GP consultations (p < 0.001). Thirty-five percent of children were documented as being palliative, with 54% having some form of advance care planning discussions documented.

These results demonstrate that GPs are highly involved in providing pediatric palliative care. The palliative nature of these children and advance care planning discussions are not routinely documented and/or performed by GPs. Further insights into guidance that supports GPs, in collaboration with other healthcare professionals, in providing palliative care for children at home and their families are needed.

Irritable bowel syndrome (IBS) commonly co-occurs with psychological distress, including depression and anxiety, but the temporal and bidirectional nature of this relationship remains unclear. Dysregulation of the gut–brain–microbiota axis has been proposed as a shared mechanism.

We conducted two retrospective, population-based cohort studies using Taiwan’s National Health Insurance Research Database (2000–2015). Cohort 1 assessed the risk of incident IBS among patients with newly diagnosed depression or anxiety, while Cohort 2 evaluated the risk of subsequent depression or anxiety among patients with newly diagnosed IBS. Propensity score matching, multivariable Cox regression, and Fine–Gray competing risk models were applied.

IBS was associated with increased risks of depression (adjusted hazard ratio [aHR] = 1.55) and anxiety (aHR = 1.68). Conversely, depression and anxiety were associated with higher risks of developing IBS (aHR = 1.45 and 1.51, respectively). Associations were stronger among females and younger adults aged 18–39 years. Sleep disorders (SDs) showed the strongest modifying effect in both directions (sub-distribution HR ≈ 1.60). Results were consistent across sensitivity analyses.

This nationwide longitudinal study demonstrates a robust bidirectional association between IBS and psychological distress, supporting integrated screening and multidisciplinary care approaches targeting gut–brain interactions.

Cumulative stress exposure is extensively involved in carcinogenesis. However, cancer risk associated with allostatic load (AL), a valid measure of chronic stress, has not been comprehensively evaluated in large cohorts, and the combined effect of AL and personality trait on cancer risk remains unknown.

This prospective cohort study was conducted based on 245,683 participants from the UK Biobank, with a median follow-up of 13.5 years. The AL score was calculated based on 11 biomarkers. Personality traits were constructed and categorized into two clusters. Multivariable Cox regression model was used to assess the risk of incident cancer according to AL and personality clusters, and multiplicative and additive interactions were evaluated.

High AL was associated with an increased cancer risk compared to low AL (hazard ratio [HR] = 1.06, 95% confidence interval [CI]: 1.04–1.09), particularly for cancers of stomach, liver, kidney, esophageal, lung, colorectal, breast, and leukemia (HR ranged from 1.08 to 1.43). Personality clusters was associated with risk of lung cancer (HR = 1.14, 95% CI: 1.05–1.23), but not overall cancer. Significant synergistic interaction was observed between high AL and ‘nervous-dominant’ personality for overall cancer risk, with the strongest association observed for liver cancer (HR = 1.58, 95% CI: 1.24–2.02).

High AL was related to higher risks of overall cancer and site-specific cancers, particularly when combined with nervous-dominant personality, highlighting the interplay between chronic physiological stress and psychological factors in cancer development.

The COVID-19 pandemic disrupted daily social interactions, potentially affecting mental health. Understanding the risk of depressive and anxiety symptoms is essential for guiding mental health strategies during future crises.

To explore how social networks influenced mental health outcomes during the pandemic and how these relationships changed over time.

Data from the Omtanke2020 study, a prospective cohort study of Swedish adults, were analysed using structural equation modelling (N = 10 918). Surveys at baseline and follow-up at 6 and 12 months assessed social networks, including structural components (e.g. relationship status, frequency of social contact) and perceived components (e.g. emotional support from family, feeling safe at home). Cross-lagged panel modelling was used to observe changes over time in the associations between social network indicators and depressive and anxiety symptoms.

Stronger perceived social support – specifically closeness to family, perceived warmth or love from others and increased societal cohesion – were negatively correlated with depressive and anxiety symptoms across all time points (β coefficients = −0.14 to −0.23, all P < 0.001). Social network variables consistently predicted mental health outcomes, with effect sizes remaining relatively stable over time (β coefficient = −0.17 at baseline, β coefficient = −0.21 at 1-year follow-up).

This study highlights the protective role of the social network – namely perceived social support – in combatting depressive and anxiety symptoms during the COVID-19 pandemic. Interventions that strengthen close interpersonal ties and community cohesion may help mitigate mental health impacts during future public health crises.

Major depressive episodes (MDEs) are highly recurrent in clinical samples. However, the course of MDEs and predictors of their endurance are unclear in the general youth population.

We investigated prospective factors associated with enduring MDE (the presence of 12-month DSM-IV MDE at baseline and 1 year using the Composite International Diagnostic Interview–Screening Scales) in 1,833 participants of a 1-year epidemiological youth cohort study in Hong Kong. Multivariable logistic regression models were used to examine the influences of a range of personal and environmental factors.

At baseline, 13.7% participants had MDEs, among whom 21.1% presented enduring MDEs. More severe symptoms of post-traumatic stress disorder (adjusted odds ratio [aOR] = 5.54, confidence interval [CI] = 2.14–14.38), depression (aOR = 3.92, CI = 1.79–8.62), and generalized anxiety (aOR = 2.27, CI = 1.21–4.25) at baseline were among the strongest associated factors for enduring MDE, with trends of associations observed for psychotic-like experiences (aOR = 1.98, CI = 0.98–4.02) and eating disorder symptoms (aOR = 1.88, CI = 0.90–3.95). Among various types of stressors, only dependent stressors at follow-up showed a clear association with enduring MDE (aOR = 4.22, CI = 1.81–9.83). Those with enduring MDE showed poorer functioning and mental health-related quality of life at follow-up, with only 35.6% having sought any psychiatric/psychological help during the past year.

Detecting comorbid symptoms in those with prior MDEs and reducing the impact of dependent stressors may help reduce their long-term implications. Enhancing the accessibility and acceptability of youth-targeted mental health services would also be crucial to improve help-seeking.