Adverse childhood experiences are critical contributors to the development of psychiatric disorders. Despite its pervasive impact on mental health, childhood neglect remains underexplored. Here, we performed a first comprehensive synthesis of the association between neglect subtypes and psychiatric disorders.

The primary aim was to quantify the overall association between neglect and psychiatric disorders, by estimating the odds ratios from clinical and control groups. The secondary aim was to examine the association between unspecified, physical and emotional neglect, and specific psychiatric disorders.

Studies were systematically selected from three databases (PubMed, EMBASE and PsycINFO), focusing on adult populations with diagnosed psychiatric disorders and corresponding control groups. Meta-analyses assessed overall associations between neglect and psychiatric disorders, as well as subtypes-specific associations with distinct psychiatric conditions. Multiple meta-regressions were performed to explore moderating factors.

Strong associations were found between neglect and psychiatric disorders across all subtypes (unspecified neglect: odds ratio 3.63, 95% CI 2.19–6.01; physical neglect: odds ratio 3.27, 95% CI 2.51–4.25; emotional neglect: odds ratio 3.36, 95% CI 2.58–4.38). Subgroup analyses showed the strongest associations between unspecified neglect and bipolar disorder, physical neglect and schizophrenia spectrum disorders, and emotional neglect and major depressive disorder. Other associations emerged, although their interpretation was limited by a small number of studies and high heterogeneity levels.

Neglect is significantly associated with psychiatric disorders, with distinct patterns across neglect subtypes and mental health outcomes. These findings highlight the need for early identification and tailored interventions to mitigate neglect’s long-term burden on mental health.

Purpose in life is consistently associated with better health outcomes, including lower risk of earlier mortality. We report an updated meta-analysis of the published literature, combined with analysis of individual-participant data, to address replicability, generalizability, and potential mechanisms of the association between purpose in life and risk of mortality.

A random-effects meta-analysis of individual-participant data from ongoing longitudinal studies (k = 8) combined with findings from a systematic review of the published literature (k = 17 samples from 14 publications). Across the 25 samples, there were 488,765 participants, 48,928 deaths, and up to 32 years of follow-up.

Purpose in life was associated with a ~ 30% lower risk of earlier mortality (meta-analytic HR = .76 [1/.76 = 1.32], 95% CI = .70, .83). The association was apparent across sociodemographic groups, with some small differences in magnitude by age, race, and education. The association was attenuated but persisted, controlling for behavioral and clinical risk factors for mortality (meta-analytic HR = .85, 95% CI = .82, .89), or depression (meta-analytic HR = .91, 95% CI = .88, .94).

A meta-analysis of 25 samples from the United States, Europe, and Asia indicated that purpose in life has a consistent association with lower risk of mortality. The association is due in part but not completely to behavioral, clinical, and psychological risk factors for earlier mortality.

Behavioural activation is effective for depression, but its effectiveness in treating adults with depression when delivered by lay workers remains unclear.

To examine the effectiveness of behavioural activation delivered by lay workers, compared with any control group, in reducing depressive symptoms in adults.

This systematic review searched six databases from inception to January 2025, for randomised controlled trials (RCTs) comparing behavioural activation and any control conditions for individuals with depression when delivered by lay workers. Additional searches were conducted in the international trial registries and reference lists (PROSPERO registration CRD42024625620). Risk of bias was assessed using the Cochrane Collaboration’s Risk-of-Bias 2 tool. Random effects meta-analysis was conducted using the Metafor package in R.

Of 9614 initial studies, six RCTs met the inclusion criteria and were included. A total of 1118 participants in the intervention groups and 1596 in the control groups. The findings demonstrated a small but statistically significant effect in reducing depressive symptoms in favour of the intervention group (standardised mean difference: −0.28, 95% CI −0.46 to −0.09; p = 0.0029). However, the risk of bias was high across all studies, with substantial heterogeneity (I2 = 76%).

Evidence from this review and meta-analysis suggests that behavioural activation, when delivered by trained lay workers, may offer an effective approach for reducing depressive symptoms in adults, particularly in settings with limited access to specialist mental healthcare professionals. However, high risk of bias and heterogeneity of the included studies means that these findings should be interpreted with caution.

Virtual reality is a promising intervention for schizophrenia spectrum disorders (SSDs), offering immersive environments to support therapy. However, evidence for its effectiveness across symptom domains remains inconsistent.

To assess the effectiveness of virtual reality-based therapies (VRT) for SSDs on symptomatology and psychosocial functioning compared with control conditions.

A systematic review and meta-analysis of controlled trials using virtual reality for individuals with SSDs was conducted. Searches were conducted across PubMed, PsychINFO, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials, from inception to March 2025. Random-effects models estimated pooled effect sizes (Hedges’ g) across outcomes, including Positive and Negative Symptom Scale, depression, paranoia and cognition. Risk of bias was assessed using the Joanna Briggs Institute Risk of Bias Tool.

From 2878 unique studies, 9 trials were eligible for meta-analysis. VRT was significantly more effective than control conditions in reducing overall psychotic symptoms (Hedges’ g = 0.53, p = 0.037). No significant effects were found for other domains (positive, negative, depressive or paranoia symptoms).

Virtual reality therapies are moderately effective at reducing overall psychotic symptoms. Unlike prior reviews, this study did not find significant effects on positive symptoms, possibly due to the heterogeneity of outcomes reported in existing interventions.

PROSPERO: CRD42023470849

Patients with inflammatory bowel disease (IBD) may be at increased risk of complications following lumbar spine surgery due to systemic inflammation, immunosuppressive therapy and nutritional deficiencies. This systematic review and meta-analysis evaluated the comparative outcomes of lumbar spinal surgery in patients with and without IBD.

We searched five databases through June 2025 for randomized and observational studies comparing postoperative outcomes of lumbar spine surgery of any type between adult patients with and without IBD. A random-effects meta-analysis was performed using the DerSimonian and Laird method.

Four retrospective cohort studies encompassing 878,116 patients (15,763 with IBD and 564,733 controls) were included. IBD patients had significantly higher odds of multiple adverse outcomes, including any complication (OR = 1.63, 95% CI: 1.08–2.47), serious adverse events (OR = 1.68, 95% CI: 1.39–2.02), minor adverse events (OR = 2.04, 95% CI: 1.63–2.55), wound infections (OR = 1.21, 95% CI: 1.08–1.35), venous thromboembolic events (OR = 1.86, 95% CI: 1.49–2.32), pneumonia (OR = 2.31, 95% CI: 1.93–2.77), urinary tract infections (OR = 2.29, 95% CI: 1.35–3.87), acute kidney injury (OR = 1.91, 95% CI: 1.68–2.17) and blood transfusions (OR = 1.64, 95% CI: 1.29–2.08). Myocardial infarction (OR = 1.76, 95% CI: 1.40–2.23) was also more common in IBD patients. No significant difference was observed in 90-day hospital readmissions.

Patients with IBD may experience significantly increased risks of postoperative complications after lumbar spine surgery. However, substantial heterogeneity among retrospective studies limits the strength of causal inferences. These findings highlight the importance of tailored perioperative management and risk counseling in this population.

The primary effect parameter in depression trials is usually a measure of depressive symptoms, e.g. the Hamilton Depression Rating Scale (HDRS). Such measures have been criticised for not covering patient-relevant domains, such as quality of life, and hence not accurately reflecting patient-experienced efficacy.

To investigate the relation between clinician-rated depressive symptoms and patient-reported quality of life measured by the Quality-of-Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF).

We included data from six acute-phase trials (n = 918) comparing mirtazapine to another antidepressant (amitriptyline, fluoxetine, paroxetine or venlafaxine) where both HDRS and Q-LES-Q-SF had been administered. No study included a placebo arm. Correlations between instruments (scales, subscales and items) were assessed after six weeks. Q-LES-Q-SF outcomes for participants who were in HDRS-defined remission were contrasted to those from participants with more severe depressive symptoms.

Q-LES-Q-SF ratings correlated strongly with HDRS-17 (r = −0.73, p < 0.0001) and HDRS-6 (r = −0.72, p < 0.0001), but somewhat weaker to HDRS-11 (r = −0.64, p < 0.0001). Depressed mood (r = −0.66, p < 0.0001) and work and activities (r = −0.65, p < 0.0001) showed the strongest item-level correlations to Q-LES-Q-SF. Participants in HDRS-remission had average Q-LES-Q-SF scores on the lower end of those reported by healthy controls, whereas patients with mild depressive symptoms (or worse) had average life-quality scores corresponding to severe impairment.

HDRS and Q-LES-Q-SF showed considerable agreement in depressed study participants treated with antidepressants, suggesting that HDRS meaningfully reflects patient-reported improvement.

To evaluate the efficacy and safety of stellate ganglion block for persistent and refractory sensorineural olfactory dysfunction.

A systematic search of PubMed, Scopus, Embase, Web of Science, Google Scholar and the Cochrane Library was conducted for studies published before December 2025. Eligible studies assessed subjective and/or objective olfactory outcomes before and after stellate ganglion block and, when available, compared stellate ganglion block with placebo or no treatment.

Nine studies involving 441 participants were included. Stellate ganglion block was associated with greater improvements in olfactory composite, identification and subjective scores than controls, but between-group differences were not statistically significant. Subjective and objective improvement rates following stellate ganglion block were 68.9 and 63.4 per cent, respectively. No major adverse events were reported.

Stellate ganglion block appears safe and may provide modest olfactory improvement, but its superiority over control treatments remains unproven, warranting further randomised controlled trials.

People with schizophrenia spectrum disorders (SSDs) experience high rates of obesity and metabolic dysfunction, contributing substantially to excess morbidity and mortality. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) such as semaglutide and tirzepatide have demonstrated substantial efficacy for weight and glycaemic outcomes in the general population, but evidence in people with SSDs remains limited.

To synthesise all placebo-controlled, randomised controlled trials (RCTs) examining semaglutide and/or tirzepatide in people with SSDs.

A preregistered systematic review and meta-analysis of RCTs examining the efficacy and safety of semaglutide and/or tirzepatide in adults with SSDs was conducted. Outcomes and adverse events were pooled using random-effects meta-analysis. Certainty of evidence was assessed using the GRADE criteria.

Three trials (n = 258) met inclusion criteria, examining semaglutide dosages of 1.0–2.0 mg over 26–36 weeks. No trials examining tirzepatide were found. Semaglutide significantly reduced body weight (−11.32 kg; 95% CI −15.35 to −7.29), body mass index (−3.58 kg/m2; 95% CI −4.86 to −2.30), haemoglobin A1c (−0.37%; 95% CI −0.51 to −0.22) and fasting glucose (−0.54 mmol/L; 95% CI −0.94 to −0.13). In adverse event analyses, semaglutide was associated with increased risks of abdominal pain (risk ratio 2.93; 95% CI 1.13–7.60), vomiting (risk ratio 2.57; 95% CI 1.39–4.77) and constipation (risk ratio 3.23; 95% CI 1.14–9.18). There was no evidence of increased risk of serious adverse events.

Semaglutide produces clinically meaningful improvements in weight and glycaemic outcomes in people with SSDs, with an adverse event profile consistent with known gastrointestinal effects of GLP-1 RAs in the general population. These findings support semaglutide as a promising adjunctive metabolic intervention in this population, although larger and longer trials, specifically those testing tirzepatide, are needed to better characterise heterogeneity of effects and long-term safety of these promising pharmacological treatments.

Anxiety disorders are associated with disrupted amygdala connectivity; however, resting-state functional MRI studies have reported heterogeneous findings. To clarify these inconsistencies, we conducted a meta-analysis of amygdala-based connectivity studies.

A systematic search of Embase, PubMed, and Web of Science was performed through December 26, 2025. Studies comparing amygdala-based whole-brain resting-state functional connectivity in patients with anxiety disorders versus healthy controls were included. Meta-analysis was conducted with the latest software – Seed-based d Mapping with Permutation of Subject Images (SDM-PSI), which employs voxel-wise tests and multiple corrections to minimize false positives. Subgroup analyses were performed to examine differences by age and hemisphere.

Fifteen datasets (378 patients, 405 controls) were included. Compared to healthy controls, patients with anxiety disorders had decreased amygdala-anterior cingulate cortex (ACC, g = −0.54, 95% confidence interval [CI]: −0.73 to −0.35) connectivity and increased connectivity with the left superior temporal gyrus (g = 0.46, 95% CI: 0.27–0.65), middle temporal gyrus (g = 0.38, 95% CI: 0.19–0.57), and cuneus (g = 0.35, 95% CI: 0.17–0.53). After threshold-free cluster enhancement correction, only reduced amygdala-ACC connectivity remained significant (g = −0.54, 95% CI: −0.73 to −0.35). Subgroup analyses confirmed this effect was driven mainly by adult patients and the left amygdala.

Reduced connectivity between the left amygdala and the ipsilateral ACC was the most robust neuroimaging marker of anxiety disorders, which suggests a lateralized vulnerability. By applying updated analytic methods, this study refines our understanding of the neuropathology of anxiety disorders and provides a potential primary target for biomarker development and novel interventions.