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.

Intolerance of uncertainty (IU) – a dispositional inability to react effectively to uncertain situations – has been increasingly conceptualized as a transdiagnostic risk factor for internalizing problems such as generalized anxiety and depression. However, evidence for its temporal role in the development of these conditions remains limited, particularly in adolescents, a group at heightened risk for psychopathology.

A total of 5,291 adolescents (46.2% boys; M age = 14.40 ± 1.56, range = 10–18 years) completed self-report measures of IU, generalized anxiety and depressive symptoms at baseline, 6 months and 12 months. Linear and logistic regression analyses examined whether baseline IU predicted subsequent symptom severity and elevated (above-cut-off) symptom levels over time.

Higher baseline IU significantly predicted increases in generalized anxiety and depressive symptoms, as well as higher odds of elevated generalized anxiety and depressive symptom levels at both 6- and 12-month follow-ups, even after adjusting for baseline symptom severity or baseline elevated symptom status. Baseline IU also predicted the new-onset and persistence of elevated symptoms across both intervals. Stratified analyses revealed developmental and sex differences: IU’s predictive effects were strongest in early adolescence for girls and in middle-to-late adolescence for boys.

IU emerged as a transdiagnostic longitudinal predictor of generalized anxiety and depressive symptoms in adolescents, supporting its value as an early screening marker of vulnerability. Interventions targeting IU may offer an effective strategy for reducing broad internalizing risk during this critical developmental period.

Reducing stigma and discrimination towards people with mental ill-health is a key priority in Australian mental health policy. Population-based surveys conducted in Australia between 2003 and 2011 showed some improvement in stigmatising attitudes, but also a deterioration in attitudes about dangerousness and unpredictability, particularly in relation to schizophrenia. This study aimed to investigate whether stigmatising attitudes have changed since the 2011 national survey.

Two large, nationally representative samples of Australian adults were surveyed in 2011 (n = 1967) and 2024 (n = 1984). At each time point, participants were presented with vignettes of a person in the early stages of depression or schizophrenia and completed questionnaires about stigmatising attitudes towards the person in the vignette (Personal Stigma Scale) and willingness to interact with them (Social Distance Scale). Using weighted data, logistic regressions assessed change from 2011 to 2024 while controlling for sociodemographic characteristics. Results were considered significant at p < .01.

There were significant reductions in endorsement of stigmatising attitudes towards depression and early schizophrenia. Notably, there were large reductions in beliefs about dangerousness (depression 22.5–4.8% and schizophrenia 37.1–18.1%). Conversely, the willingness to interact with a person with depression remained unchanged and had worsened for schizophrenia, with the odds of being unwilling to interact approximately doubling (11.0–26.9% unwilling to make friends and 18.8–33.2% unwilling to work closely with them).

The data show mixed findings regarding change in stigma in the Australian population. Despite negative beliefs diminishing over time, this has not translated into greater willingness to interact with people with depression or schizophrenia. Key action is needed on understanding the barriers to interacting with people with mental health conditions and reducing perceptions of unpredictability, particularly for schizophrenia, which remains more highly stigmatised.

The PReDicT study showed that predictive algorithm-guided antidepressant treatment reduces anxiety and improves functioning in patients with depression.

To estimate the costs, outcomes and cost-effectiveness of the PReDicT test compared with treatment as usual (TAU) for primary depression care in five European countries.

Within-trial economic analysis was conducted over 24 weeks from the health/social care and societal perspectives alongside the PReDicT trial (NCT02790970) in France, Germany, The Netherlands, Spain, and the UK, according to Consolidated Health Economic Evaluation Reporting Standards guidelines. We calculated quality-adjusted life-years (QALYs) based on the EQ-5D-5L, capability-weighted life-years based on the Oxford Capabilities Questionnaire – Mental Health (OxCAP-MH) (Germany and UK only), and costs for 2018 (€). Multiple imputation for missing data, multivariable regression for cost and outcome differences, and bootstrapping and sensitivity analyses for uncertainty were conducted.

There were significant outcome improvements (EQ-5D-5L PRedicT: +0.139; TAU: +0.140) and societal cost reductions (PRedicT: −€2589; TAU: −€2602) in both groups (N = 913) between the before and during trial periods. In the UK and Germany (n = 619), the PReDicT group showed significant additional capability well-being gains (OxCAP-MH: +2.127, p = 0.021). Cost-effectiveness probabilities ranged from 46 to 59% at trial level, but exceeded 80% in the UK. Results remained stable across different sensitivity analyses, with societal cost-effectiveness improved for those (self-)employed.

We observed potentially meaningful health and economic benefits of closely monitored antidepressant treatment, as implemented in both treatment and control arms of the PReDicT trial. The PReDicT test itself had some added benefits in improved capabilities and productivity, however, with great uncertainty and country-level variations in cost-effectiveness.

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.

Child maltreatment is strongly linked to depression, yet comparisons across maltreatment forms have been inconsistent. Prior meta-analyses mostly used single-level models and combined studies assessing different subsets of maltreatment forms, introducing statistical dependence and between-samples confounds that can distort cross-form comparisons.

We synthesized data from 12 eligible meta-analytic reviews (those assessing at least emotional, physical, and sexual abuse, and providing effect size data), extracting 563 effect sizes from 217 depression risk studies and 501 effect sizes from 157 depression severity studies. Meta-analyses used two-level random-effects multilevel models, accounting for within-study dependence. Initial analyses compared all abuse forms plus emotional and physical neglect. Subsequent analyses compared just abuse forms either from samples assessing all three (‘complete-abuse’ samples) or only one or two (‘incomplete-abuse’ samples), which addressed between-samples confounds.

Effect sizes for different maltreatment forms were strongly correlated within studies (median rs ≈ .46–.48), confirming statistical dependence. Across all analytic layers, emotional abuse showed the strongest association with depression, and sexual abuse the weakest. In complete-abuse studies – the most internally comparable designs – a clear hierarchy emerged: emotional abuse > physical abuse > sexual abuse for both risk and severity. Incomplete-abuse studies obscured these differences.

By modeling effect size dependence and reducing between-samples confounds, this study provides clearer evidence that emotional maltreatment – particularly emotional abuse – is most strongly linked to depression. These findings underscore the need for greater clinical and prevention focus on emotional forms of maltreatment.

The triglyceride–glucose (TyG) index, a surrogate marker for insulin resistance, has been associated with depressive symptoms, but findings are inconsistent and predominantly based on cross-sectional studies. This study investigated whether the TyG index is associated with incident depression independent of genetic predisposition and explored potential risk factors underlying this association.

A total of 335,586 UK Biobank participants without baseline depression were included. Incident depression cases were extracted by linking electronic health records. Polygenic risk scores quantified genetic predisposition. Cox proportional hazards models examined the associations. We further evaluated the contribution of socioeconomic status (education, employment, and Townsend Deprivation Index), lifestyle factors (smoking, alcohol consumption, physical activity, and sleep duration), biological indicators (body mass index and total cholesterol), and health conditions (hypertension, diabetes, and cardiovascular disease). No preregistered protocol was used.

During a mean follow-up of 13.1 years, 14,096 (4.2%) individuals developed depression. Compared with the lowest TyG quartile (Q1), the fully adjusted hazard ratios (95% confidence intervals) for Q2, Q3, and Q4 were 1.051 (1.000–1.104), 1.078 (1.025–1.134), and 1.144 (1.086–1.206), respectively (P for trend <0.001). Per standard deviation increment in the TyG index was associated with a 5.9% (3.9%–7.8%) higher risk of depression. Individuals with both high TyG levels and high genetic predisposition had the highest risk, although no significant interaction was observed. All adjusted risk factors appeared to attenuate 63.9% of the association.

A higher TyG index was associated with increased risk of incident depression, independent of genetic predisposition.

To examine mediators and modifiable psychosocial factors associated with psychological distress, depression, anxiety and self-rated health among Aboriginal and Torres Strait Islander peoples (hereafter respectfully referred to as ‘Indigenous Australians’) aged ≥18 years.

This was a cross-sectional study based on the analysis of the 2018–19 National Aboriginal and Torres Strait Islander Health Survey dataset (N = 3942). Odds ratios (OR) and 95% confidence intervals (CI) for associations and indirect effects for mediation analyses were computed.

Our results showed that Indigenous Australians with higher levels of perceived social support were less likely to have psychological distress (OR = 0.36, 95% CI: 0.23, 0.56), depression (OR = 0.44, 95% CI: 0.29, 0.67), anxiety (OR = 0.43, 95% CI: 0.28, 0.65) and low self-rated health (OR = 0.52, 95% CI: 0.33, 0.82). Similarly, those with a high level of mastery were less likely to have psychological distress (OR = 0.14, 95% CI: 0.11, 0.19), depression (OR = 0.20, 95% CI: 0.15, 0.28), anxiety (OR = 0.26, 95% CI: 0.20, 0.36), and low self-rated health (OR = 0.37, 95% CI: 0.28, 0.50). Perceived social support mediated 33.7% of the association between removal from the natural family and psychological distress, 14.6% of the association between discrimination and psychological distress, 20.3% of the association between discrimination and depression, 14.8% of the association between discrimination and anxiety and 16.6% of the association between discrimination and low self-rated health. Both perceived social support and mastery mediated the association between physical harm and psychological distress, depression and anxiety.

We believe that community-driven psychosocial programs that enhance social support, self-efficacy and cultural connection may significantly improve the mental health and psychosocial well-being of Indigenous Australians.