Successful surgery for Cushing’s disease (CD) leads to an abrupt change in cortisol levels, and patients often experience symptoms that can adversely affect their quality of life (QOL). The goal of this study was to provide a detailed characterization of the changes in QOL before and after successful surgery.

The QOL-CD, a CD-specific questionnaire, was administered at routine clinical visits during active disease prior to surgery and during the early postoperative phase following successful surgery. Descriptive statistics and nonparametric tests characterized clinical, endocrinological, and ophthalmological attributes at both phases. Euclidean hierarchical clustering of the 34 patients who completed both pre- and postoperative questionnaires identified latent subgroups of QOL change.

In the cohort as a whole, hypertension (OR = 0.31, p = .003), emotional health (p = .026) and physical health (p < .001) improved following treatment. Changes in emotional health were correlated with changes in mental status (r = 0.66, p < .001) and social well-being (r = 0.53, p = .001). The cluster analysis revealed five distinct patterns of pre- to postoperative changes in QOL domains, grouped into three categories based on severity. Group 1 (n = 5) patients showed worsening in most domains of QOL, Group 2 (n = 20) showed marginal changes in QOL and Group 3 (n = 9) demonstrated improvements across all QOL domains.

Our results highlight the need to educate and support patients before and after surgery for CD. Long-term follow-up studies are needed to better understand the trajectory of QOL recovery and to identify predictors of treatment response.

Functional neurological disorder (FND) is a common condition, but there remain substantial gaps in our understanding of its effects, particularly on severity of disability and health status.

To characterise disability, quality of life and psychological and somatic symptom comorbidity in individuals with FND attending a specialist multidisciplinary clinic in Australia.

We conducted a cross-sectional analysis of patients assessed at an FND clinic in Sydney, Australia, between August 2022 and February 2025. We assessed disability (World Health Organization Disability Assessment Schedule (WHODAS 2.0)), health-related quality of life (EQ-5D five-level version (EQ-5D-5L), 36-Item Short Form Health Survey), psychological distress (Depression Anxiety and Stress Scale-21, Kessler Psychological Distress Scale (K10)) and somatic symptom severity (Patient Health Questionnaire-15 (PHQ-15)).

The cohort (N = 105) was predominantly female (74.3%), with a mean age of 35.4 (s.d. = 13.3) years. Functional seizures (46.7%) and functional weakness (45.7%) were the most common presentations. Only 33.7% were employed; 42.9% were unable to work because of FND. The average delay from diagnosis to clinic assessment was 356 days (s.d. = 463). WHODAS 2.0 scores indicated high levels of disability, exceeding international norms for both physical and mental illness. EQ-5D-5L scores were low, with 15.8% reporting a health state rated as ‘worse than death’. Psychological distress and somatic symptom severity were high: 49.5% scored in the K10 ‘very high’ range and 54.5% had high PHQ-15 scores.

FND is associated with significant functional disability, poor quality of life and high levels of psychological and somatic symptom comorbidity. Delays in accessing appropriate care and high rates of vocational disruption highlight the need for earlier diagnosis and better access to integrated, multidisciplinary FND services in Australia.

Older adults with cancer frequently experience high symptom burden, psychological distress, and reduced quality of life. Integrating palliative nursing interventions into routine oncology care has the potential to improve these outcomes, yet evidence examining their measurable effects remains limited. This study aimed to examine the effects of integrated palliative nursing interventions on quality of life, psychological outcomes, and symptom burden among older adults with cancer.

A quasi-experimental one-group pre-test–post-test design was conducted at King Khaled Hospital, Al-Kharj, Saudi Arabia, including 80 older adults (≥60 years) with confirmed cancer diagnosis. Participants received a structured 6-week integrated palliative nursing intervention comprising 12 sessions (2 sessions/week) addressing physical, psychological, social, functional, and spiritual needs. Outcome measures included the Functional Assessment of Cancer Therapy-General (FACT-G) for quality of life, the National Comprehensive Cancer Network (NCCN) Distress Thermometer for psychological outcomes, and the Edmonton Symptom Assessment System (ESAS-r) for symptom burden. Pre- and post-intervention assessments were conducted, and data were analyzed using paired t-tests, Pearson correlations, and multiple linear regression.

All 80 participants completed the study, and no attrition was observed during the 6-week intervention period. Post-intervention, participants demonstrated significant improvements in overall quality of life (FACT-G total: 39.65 ± 5.51 → 66.41 ± 6.25, p < .001) and all subscales. Distress scores (NCCN) decreased from 21.93 ± 2.49 to 6.99 ± 2.37 (p < .001), and total symptom burden (ESAS) declined from 63.56 ± 6.31 to 41.09 ± 6.88 (p < .001). Regression analysis identified baseline scores as significant predictors of post-intervention outcomes: pre-intervention FACT-G scores and cancer type for quality of life [R2 = 0.660, F (8, 71) = 17.199, p < .001), pre-intervention NCCN scores for distress (R2 = 0.219, F (8, 71) = 2.487, p = .019), and pre-intervention ESAS scores for symptom burden (R2 = 0.757, F (8, 71) = 27.697, p < .001). These results indicated that baseline status strongly predicts post-intervention outcomes, while demographic and clinical variables had minimal impact.

Structured integrated palliative nursing interventions significantly enhance quality of life and reduce psychological distress and symptom burden in older adults with cancer. Incorporating multidimensional, patient-centered palliative care within routine oncology practice can improve clinical outcomes, with baseline status serving as an important determinant of intervention effectiveness.

Improving quality of life (QoL) is a primary objective in the treatment of schizophrenia. The current analysis aimed to evaluate the impact of antipsychotic administration routes on QoL in early-phase schizophrenia (SZ) patients randomized to treatment with either long-acting injectable (LAI) or oral aripiprazole or paliperidone as part of the “European Long-acting Antipsychotics in Schizophrenia Trial” (EULAST).

A total of 492 patients were followed for up to 19 months. QoL was assessed using the EQ-5D-5L. In the primary analysis, the relationships between oral versus LAI treatment and between treatment with paliperidone versus aripiprazole were investigated by fitting generalized estimating equation models. In secondary analyses, we examined the individual dimensions of the EQ-5D-5L, including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. In subgroup analyses, we estimated the treatment effect on the EQ-5D-5L across clinically relevant subgroups, including sex, age, symptomatology, and side effects.

Overall, EQ-5D-5L scores improved over the course of the study, with no significant differences between patients treated with LAI versus oral antipsychotics (p = 0.662) or between those treated with aripiprazole versus paliperidone (p = 0.266). Subgroup analyses based on sex, age, medication side effects, and psychopathology also did not reveal any significant differences in EQ-5D-5L outcomes between LAI and oral antipsychotic treatment.

These findings indicate comparable QoL in SZ patients starting LAI or oral antipsychotic treatment with aripiprazole or paliperidone. Further research with extended follow-up periods is required to gain deeper insights into potential subgroup-specific benefits and the long-term effects of different antipsychotic administration routes on QoL.

This study investigates the relationships between family burden, perceived social support, quality of life and happiness among mothers of individuals with intellectual and developmental disabilities (IDDs).

This study aimed to examine the relationship between family burden and maternal happiness, and to investigate the serial mediating roles of perceived social support and family quality of life in mothers of children with IDDs.

The study sample comprised 250 mothers of children with IDDs. Data were collected using validated instruments: The Multidimensional Scale of Perceived Social Support, a family burden scale, the Beach Center Family Quality of Life Scale and the Oxford Happiness Questionnaire Short Form. Descriptive statistics, correlation analyses and structural equation modelling were conducted with software SPSS 26.0 and JASP 0.16.4.

Perceived social support and family quality of life were positively associated with happiness and negatively associated with caregiving burden; structural equation modelling indicated that their sequential mediation fully explained the link between family burden and happiness.

The findings underscore the critical role of social support and family quality of life in mitigating the negative impact of caregiving burden on maternal happiness.

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.

This study aimed to compare Merocel and Surgicel nasal packing following inferior turbinoplasty, focusing on post-operative bleeding, pain, discomfort and nasal obstruction.

A randomised controlled trial (2017–2021) was conducted in the Department of Otolaryngology, Changi General Hospital, Singapore. Sixty adults undergoing inferior turbinoplasty and/or septoplasty were randomised to receive Merocel or Surgicel packing. Standardised surgical and post-operative protocols were used. Outcomes—bleeding, pain, discomfort and nasal obstruction—were assessed on post-operative day 1 and post-operative days 5–7 using validated scales.

Fifty-eight patients completed the study (Merocel = 30; Surgicel = 28). On post-operative day 1, Surgicel had significantly lower nasal obstruction scores (1.57 ± 0.74 vs 2.10 ± 0.71; p = 0.008). By post-operative days 5–7, Merocel showed significantly less bleeding (0.77 ± 0.63 vs 1.18 ± 0.86; p = 0.044). Pain and discomfort were comparable.

Merocel provided superior sustained haemostasis, while Surgicel offered better early comfort. Both materials have comparable outcomes.

The objective was to identify, critically appraise, and synthesize evidence on the effectiveness of dance interventions on quality of life (QoL) for adults aged 60+ living in long-term care (LTC).

A systematic review, initiated and co-led by patient partners, was conducted following a search across eight electronic databases. Eligible studies included randomized controlled trials, quasi-experimental, and observational designs reporting QoL or health-related QoL outcomes. Reviewers independently completed title/abstract and full-text screening. Data extraction included study characteristics, intervention details, outcome measures, use of theory, proposed mechanisms of action, and intervention effectiveness.

Seven studies involving 429 participants were included. Six studies reported improvements in QoL or health-related QoL. Five studies used a dance intervention targeted to a specific country or cultural group. Two studies identified potential mechanisms of action.

Dance interventions may improve QoL in older adults living in LTC. Research with more theory-driven, mixed methods, and/or co-created designs is needed.

The Mediterranean Diet (MedDiet) and physical activity (PA) can enhance mood and support psychological wellbeing in adults. However, the combined effect is relatively unknown. MedWalk aimed to determine the combined effect on wellbeing, psychological health and quality of life (QoL), compared to a control group.

This is an analysis of secondary outcomes from the MedWalk 12-month cluster-randomised controlled trial. Participants completed the Total and Secure Flourishing Index (FI), the four domain General Health Questionnaire (GHQ-28) and the 8-domain Assessment of Quality of Life (AQoL-8D). Data were analysed using general linear models using change scores (FI and AQoL-8D) or generalised linear mixed models with a time × group interaction effect (GHQ-28).

Independent living facilities across South Australia and Victoria in 2021–2022.

One hundred and sixty-one older men and women.

Participants were 74·9 ± 5·9 years of age and predominantly female (74 %). A greater improvement was found for the MedWalk group (marginal means (MM) = 1·65, se = 1·36) than the control group (MM = –2·50, se = 1·32) for the Total Flourish score (P = 0·003) and Secure Flourish score (P = 0·009) ((MM = 1·06, se = 1·65) v. (MM = –3·34, se = 1·61)) from baseline to 6 months. The MedWalk group (MM = 0·021, se = 0·014) had more positive changes (P = 0·048) to the Mental Health AQoL-8D domain than the control group (MM = –0·007, se = 0·014). No significant group × time interactions were identified for the GHQ-28.

Combined MedDiet and walking interventions can modify psychological health, wellbeing and QoL in relatively healthy populations.

The importance of Financial Distress (FD) for German cancer patients is rising and data on FD is increasingly being collected in clinical trials. However, the role of FD in German early benefit assessments (EBAs) remains unclear. We systematically analyze the role of FD in EBAs for oncology drugs in Germany by investigating how often and for what reasons FD is excluded for EBA by pharmaceutical companies, how often and in which ways FD is referenced in scientific assessments by German HTA authorities (IQWiG and G-BA), and how FD influences added benefit decisions.

Our analysis covered all completed, currently valid German EBAs of oncology drugs from 2011 to 2024. We calculated exclusion rates, reference rates and benefit decisions, stratified by drug type, FD results, exclusion and reference status. In qualitative analyses, we inductively categorized reasons for FD exclusion and types of FD references.

FD currently plays at most a subordinated role for German EBAs across all involved stakeholders. Almost half of dossier submissions excluded FD from EBA, even though data on FD was collected. The IQWiG referenced FD in only 25 percent of their scientific assessments. Furthermore, the G-BA referenced FD in only three out of 215 justifications of resolution. HTA authorities have divergent and inconsistent approaches to FD.

German HTA authorities should strengthen the role of patient-reported outcomes and provide clearer methodological guidance for integrating psychosocial dimensions such as FD. Future research should focus on refining measurement strategies to better capture the multidimensional nature of FD.

Individuals with severe mental illnesses (SMIs) experience anxiety that impairs functioning and quality of life. This cluster randomized trial evaluated exposure-based cognitive behavioral therapy (ebCBT) integrated into assertive community treatment (ACT) teams to reduce anxiety.

Fifteen ACT teams were allocated to ebCBT + ACT (k = 8, n = 50) or ACT-only (k = 7, n = 43). The intervention followed four steps: situation identification, four-component analysis (behavior, cognition, emotion, physical symptoms), psychoeducation, and graded exposure. Staff received 50 h training and bimonthly supervision over 12 months. Co-primary outcomes were trait and social anxiety; secondary outcomes were psychiatric symptoms, functioning, quality of life, and recovery.

The ebCBT + ACT group showed significant improvements in State–Trait Anxiety Inventory–Trait scores at 12 months (AMD = −5.30, 95% CI = −8.71 to −1.90, p = 0.002, d = −0.64) and 18 months (AMD = −7.22, 95% CI = −12.1 to −2.34, p = 0.004, d = −0.60). Brief Fear of Negative Evaluation scores showed near-significant improvement at 18 months (AMD = −3.70, 95% CI = −7.44 to 0.04, p = 0.052, d = −0.40). Secondary outcomes, including global functioning, recovery, and quality of life, also improved. Cost-effectiveness analyses indicated favorable cost-effectiveness for anxiety outcomes.

Embedding ebCBT within ACT services may reduce anxiety-related fear and avoidance and enhance recovery-related outcomes in individuals with SMI. These findings support the feasibility and clinical value of integrating structured psychological interventions into intensive community-based outreach services.

To examine the relationships between patient activation, depressive symptoms, and quality of life among older adults receiving palliative oncology care.

A cross-sectional correlational study was conducted among 145 adults aged ≥60 years receiving palliative oncology care at King Khalid Hospital, Saudi Arabia, using stratified random sampling. Data were collected via a demographic and clinical questionnaire, the Patient Activation Measure-13 (PAM-13), the Patient Health Questionnaire-9 (PHQ-9), and the McGill Quality of Life Questionnaire–Revised (MQOL-R). Descriptive statistics, Pearson correlation, independent t-tests, one-way ANOVA, and multiple linear regression were performed using SPSS version 26.

All participants demonstrated Level 2 patient activation, with a mean PAM-13 score of 50.83 (SD = 1.04). Moderate depressive symptoms were prevalent (mean PHQ-9 = 13.56, SD = 3.48), and overall quality of life was moderate (mean MQOL-R = 55.21, SD = 10.14). Patient activation was weakly but significantly inversely correlated with depressive symptoms (r = −0.179, p < 0.05). No significant associations were found between patient activation and quality of life, or between depressive symptoms and quality of life. Regression analysis showed that patient activation, depressive symptoms, and demographics accounted for only 3.2% of the variance in quality of life (R2 = 0.032, p = 0.714).

Patient activation may modestly reduce depressive symptoms but is not sufficient to improve quality of life in older adults receiving palliative oncology care. Quality of life appears influenced by broader multidimensional factors beyond activation and mood, highlighting the need for comprehensive interventions in palliative care settings.

Quality of life (QoL) is an important clinical outcome in mental health. However, evidence on its progression and predictors in individuals at clinical high risk for psychosis (CHR-P) remains limited. This meta-analysis examined correlates, impact, and longitudinal changes in QoL among CHR-P individuals.

Following PRISMA guidelines (PROSPERO: CRD42024560092), we systematically searched multiple databases from inception to 27 May 2025. Eligible studies included CHR-P participants assessed with validated QoL instruments. Data extraction was performed independently, and meta-analyses, meta-regressions, heterogeneity, and publication bias analyses were conducted. Risk of bias was evaluated using a modified Newcastle–Ottawa Scale (NOS).

Thirty-one studies were included (2,288 CHR-P individuals; mean age = 21.47 years; 48.9% female). Compared with healthy controls (HC), CHR-P participants showed significantly poorer QoL (Hedges’ g = 1.39, 95% CI = 0.97–1.83). Longitudinal analyses indicated QoL improvements after 1 year (Hedges’ g = 1.40, 95% CI = 0.74–2.07) and at 2–3 years follow-up (Hedges’ g = 3.24, 95% CI = 0.73–5.75). Substantial heterogeneity was observed across analyses. Meta-regressions showed no significant influence of age, sex, functioning, symptom severity, or study quality. Study quality scores ranged from 1 to 8 (median = 6, mean = 5.8, SD = 1.13).

Individuals at CHR-P present markedly poorer QoL compared with healthy controls. Longitudinal data suggest possible improvements over time; however, heterogeneity and limited long-term evidence warrant cautious interpretation. Further longitudinal studies are needed to better characterize QoL trajectories and identify subgroups requiring sustained intervention.

Hepatocellular carcinoma (HCC) is associated with high mortality and imposes substantial symptom and psychological burdens; however, the impact of different treatment modalities on quality of life (QoL) and mental health remains underexplored. This study aimed to examine the associations among symptom distress, depression, and QoL across various HCC treatments.

A cross-sectional study was conducted with 101 inpatients at a regional hospital in Taiwan (October 2020–December 2021). Patients received hepatic resection (HR), radiofrequency ablation (RFA), transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), or immunotherapy (IT). Data were collected using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30), the Hospital Anxiety and Depression Scale (HADS), and the Brief Symptom Rating Scale (BSRS).

RFA patients reported better functional scores (96.13 ± 7.55) and lower HADS scores (18.31 ± 4.92) than those treated with TACE, HAIC, or IT (function: 87.77 ± 17.77; HADS: 23.26 ± 7.66). These differences may reflect earlier disease stage and better baseline health in RFA recipients. Older age and advanced stage were associated with poorer global health (p < 0.05), while female gender (β = − 7.38, p = 0.014) and disease recurrence (β = − 6.48, p = 0.019) were associated with lower functional status.

Treatment type, disease stage, and demographics significantly shape QoL and mental health in HCC patients. Minimally invasive therapies like RFA may preserve QoL in early-stage disease, while invasive or palliative treatments necessitate greater psychosocial support.