Electroencephalography (EEG) connectomes offer powerful tools for studying brain connectivity and advancing our understanding of brain function and dysfunction in both healthy and pathological conditions. Celebrating the 100th anniversary of EEG discovery, this Perspective explores the frontiers of EEG-based brain connectivity in basic and translational neuroscience research. We review new concepts, emerging analysis frameworks and significant advances in harnessing EEG connectomes. We suggest that leveraging machine learning approaches may offer promising paths to maximize the strengths of EEG connectomes. We also discuss how combined EEG connectome and neuromodulation provide a personalized and adaptive closed-loop paradigm to promote neuroplasticity and treat dysfunctional brains. We further address the limitations and challenges of the current methodology and touch on important issues regarding research rigour and clinical viability for translational impact.

In patients with schizophrenia, cannabis use exacerbates symptoms and can lead to a relapse of psychosis. Some experimental studies in healthy volunteers suggest that pre-treatment with cannabidiol (CBD) may reduce these effects, but others do not. Here, we investigated whether pre-treatment with CBD ameliorates the acute adverse effects of cannabis in patients with schizophrenia. Participants (n = 30) had schizophrenia or schizoaffective disorder plus a comorbid cannabis use disorder. In a double-blind, randomised, placebo-controlled, crossover trial, participants received oral CBD 1000 mg or placebo three hours before inhaling vaporised cannabis (containing Δ⁹-tetrahydrocannabinol (THC) 20-60 mg). The primary outcome was delayed verbal recall measured with the Hopkins Verbal Learning Test-Revised. We also measured psychotic symptoms with the Positive and Negative Syndrome Scale (PANSS) - positive subscale. Delayed verbal recall after cannabis administration was 3.5 words (95% confidence interval [CI]: 2.5-4.5) following pre-treatment with CBD, compared to 4.8 words (95% CI: 3.9 to 5.8) following pre-treatment with placebo (mean difference [MD] = -1.3 [95% CI: -2.0 to -0.6]; p = 0.001). After CBD pre-treatment, inhalation of cannabis was associated with an increase in PANSS-P score of 5.0 (95% CI: 3.6 to 6.5), compared to 2.9 (95% CI: 1.5 to 4.3) following pre-treatment with placebo (MD = 2.2 [95% CI: 0.6 to 3.7]; p = 0.01). Administration of CBD did not have a significant effect on plasma concentration of THC or its active metabolite, 11-hydroxy-THC. In patients with schizophrenia and a comorbid cannabis use disorder, pre-treatment with CBD did not attenuate the acute effects of cannabis on memory impairment or psychotic symptoms, but appeared to exacerbate them. The study was registered on Clinicaltrials.gov (NCT04605393).

Multiple sclerosis (MS) research requires new, more sensitive, behavioral biomarkers that map to subtle central nervous system injury. Although gait speed, as measured using the Timed 25 Foot Walk Test, is used clinically to track MS progression, it is less useful in people with MS who do not have overt gait impairment. This study aimed to identify specific spatiotemporal gait parameters that predict corticospinal tract (CST) function in individuals with MS. We recruited consecutive patients attending a neurology clinic and evaluated CST excitatory and inhibitory function using single pulse transcranial magnetic stimulation of the primary motor cortex representation of the first dorsal interosseous muscle. We generated excitatory and inhibitory recruitment curves by calculating the area under the curve for motor-evoked potential amplitudes and cortical silent period durations, respectively, across stimulation intensities from 105 to 155% of active motor threshold in 10% increments. Spatiotemporal gait parameters were assessed using an electronic walkway. We built predictive models with gait parameters as the predictors and CST function as the outcome. We evaluated 78 individuals with MS (58 females). Longer distance of the center of pressure movement during single support was the strongest predictor of higher excitability (lower active motor threshold; accounting for 25.8% of variance, R² = 0.258), while less time in double support accounted for a smaller portion of variability in excitatory recruitment curve (13.3% variance explained, R² = 0.133). For inhibitory CST function, slower stride time (30.5% variance explained, R² = 0.305) and wider stride (6.3% variance explained, R² = 0.063) predicted greater inhibition. Notably, in all models, measures of gait stability, not gait speed, predicted CST function. Our results suggest that even among people with MS who have normal gait speed and can easily cross an urban intersection, subtle postural control impairments exist which may not be apparent to them or to their clinician.

Involuntary psychiatric holds, commonly limited to 72 hours, serve as a critical intervention for individuals experiencing acute mental health crises. These holds aim to prevent immediate harm and facilitate crisis stabilization, yet their effectiveness, legal variability, and long-term impact remain inadequately studied. Despite widespread implementation, the 72-hour standard lacks strong empirical justification, and significant inconsistencies exist in its application across jurisdictions.

This narrative review examines the factors leading to the initiation of involuntary psychiatric holds, focusing on legal frameworks, clinical assessment protocols, systemic challenges, and patient outcomes.

A clinically structured literature review was conducted using peer-reviewed journals and official guidance. Studies were included if they analyzed U.S. laws and practices regarding involuntary psychiatric holds, examined clinical assessment criteria, or explored patient outcomes related to psychiatric detentions. Thematic analysis was used to identify patterns, inconsistencies, and areas for future research.

Suicidality remains the leading cause for psychiatric holds, but assessment criteria vary widely. Emergency departments serve as the primary entry point, yet resource limitations and legal inconsistencies contribute to disparities in care. The historical 72-hour timeframe is not supported by robust evidence, and recidivism rates remain high due to inadequate posthold care.

Standardized protocols, expanded crisis intervention training, and improved outpatient services are essential for optimizing involuntary psychiatric holds. Further research is needed to evaluate the efficacy of the 72-hour standard and to develop policies that balance patient rights with public safety.

Living systematic reviews (LSRs) maintain an updated summary of evidence by incorporating newly published research. While they improve review currency, repeated screening and selection of new references make them labourious and difficult to maintain. Large language models (LLMs) show promise in assisting with screening and data extraction, but more work is needed to achieve the high accuracy required for evidence that informs clinical and policy decisions.

The study evaluated the effectiveness of an LLM (GPT-4o) in title and abstract screening compared with human reviewers.

Human decisions from an LSR on prodopaminergic interventions for anhedonia served as the reference standard. The baseline search results were divided into a development and a test set. Prompts guiding the LLM's eligibility assessments were refined using the development set and evaluated on the test set and two subsequent LSR updates. Consistency of the LLM outputs was also assessed.

Prompt development required 1045 records. When applied to the remaining baseline 11 939 records and two updates, the refined prompts achieved 100% sensitivity for studies ultimately included in the review after full-text screening, though sensitivity for records included by humans at the title and abstract stage varied (58-100%) across updates. Simulated workload reductions of 65-85% were observed. Prompt decisions showed high consistency, with minimal false exclusions, satisfying established screening performance benchmarks for systematic reviews.

Refined GPT-4o prompts demonstrated high sensitivity and moderate specificity while reducing human workload. This approach shows potential for integrating LLMs into systematic review workflows to enhance efficiency.

Anxiety disorders are among the most common co-occurring mental health conditions experienced by autistic youth. Without appropriate intervention, anxiety disorders and related difficulties experienced by autistic youth can remain well into adulthood, causing reduced quality of life. Behavioral Interventions for Anxiety in Children with Autism (BIACA) is a manualised, modular evidence-based cognitive behavioural therapy with demonstrated efficacy in reducing or fully remitting anxiety symptoms and improving overall adaptive functioning for autistic youth. However, BIACA has been developed and tested mostly in academic research laboratories and has involved a limited number of community clinicians. Thus, certain characteristics (eg, length, complexity) may require adaptation to facilitate adoption and use in community settings.

This mixed methods study will use and evaluate a community-engaged, intervention adaptation method (ie, Adapted version of the Method for Program Adaptation through Community Engagement (AM-PACE)) to develop an adapted version of BIACA for community use. In the current study, the AM-PACE method will involve: (1) a Community Advisory Board (CAB), (2) structured process to identify core components, (3) community feedback via surveys and semistructured interviews and (4) role play exercises with intended clients. Thereafter, community-based providers (N=200) will be asked to evaluate the feasibility, acceptability, appropriateness, usability and intent to use for the original BIACA intervention and adapted BIACA intervention. Repeated measures Analysis of Variance (ANOVA) will be conducted to determine whether programme type predicts provider ratings. Higher provider ratings for the adapted BIACA intervention may indicate adaptations identified through AM-PACE-enhanced potential for BIACA to be equitably implemented in community settings.

Ethics approval was obtained from the Michigan State University Institutional Review Board. Research findings will be published in peer-reviewed journals, presented at international conferences and disseminated in alignment with CAB recommendations.

This study has been registered on Open Science Framework: https://doi.org/10.17605/OSF.IO/Z54MD.

Personal Belief in a Just World (PBJW) has been associated with better mental health outcomes; however, the mechanisms underlying this relationship remain insufficiently understood. This study investigated whether optimism and self-efficacy mediate the effect of PBJW on depressive symptoms in a sample of 54 participants. Multiple mediation analysis was conducted, revealing that both optimism and self-efficacy significantly mediated the relationship between PBJW and Depression Score (β = -0.38, p < .001, R² = 0.15). Notably, a significant direct effect of PBJW on Depression Score persisted after accounting for the mediators (β = -0.23, p_adj = 0.027, R² = 0.05), suggesting the presence of additional explanatory mechanisms. These findings highlight optimism and self-efficacy as key psychological pathways linking PBJW to mental health, while also indicating that other relevant factors remain to be explored as the mediators account for only part of the association, leaving significant variance unexplained. Clinically, interventions that strengthen optimism and self-efficacy may enhance the mental health benefits of PBJW. Future research should investigate additional mediators and moderators, and replicate these findings in larger, more diverse samples and longitudinal designs to inform both theory and clinical practice.

Suicide is the second leading cause of death for adolescents. Children in surgical clinics have diagnoses that may predispose mental health challenges. This study explored associations between demographics, diagnoses, and suicide risk screenings in the outpatient pediatric surgical setting.

A database of suicide risk screenings administered across a pediatric surgical health care system from 2019 to 2023 was analyzed. Demographic variables and diagnoses were collected, and multilevel logistic regression models calculated odds ratio (OR) and 95% confidence interval (CI) for the relationships.

In total, 79,384 suicide risk screenings were collected for 50,796 patients. 5.6% (n = 4476) were positive for suicidal thoughts. Asians were less likely to screen positive (OR, 0.65; 95% CI, 0.56-0.76), and females were more likely (OR, 1.92; CI, 1.80-2.05). Patients with Medicaid or uninsured were more likely to screen positive (OR, 1.47; CI, 1.38-1.57 and OR, 1.17, CI, 1.002-1.36, respectively). As affluence increased, there was decreased likelihood of positive screens (OR, 0.93; CI, 0.91-0.96). The diagnosis most associated with increased risk was mental, behavioral, and neurodevelopmental disorders (OR, 3.41; CI, 2.92-3.97), followed by pain (OR, 1.88; CI, 1.71-2.05), burns (OR, 1.43; CI, 1.21-1.69), and scoliosis (OR, 1.10; CI, 1.02-1.17).

When screening for suicide risk in outpatient pediatric surgical subspecialty clinics, females and patients with Medicaid or uninsured have increased risk of screening positive for suicidal ideations. Youth with mental, behavioral, and neurodevelopmental disorders were most at risk, followed by pain, burns, and scoliosis. It is important to understand how these factors influence mental health to aid in providing resources for at-risk patients.

Psychology doctoral students confront considerable stress and elevated mental health challenges, particularly during the onset of the COVID-19 pandemic. This study examined protective factors associated with better functional outcomes in this population.

This cross-sectional study included 889 US clinical and counseling psychology doctoral students.

Protective factors, including coping strategies, resilience, social support, and physical activities were examined in relation to quality of life, anxiety and depression symptoms, and physical pain.

Multiple linear regression analysis showed protective factors predicted positive functional outcomes. Problem-focused engagement coping and aerobic activities predicted improved quality of life, lower anxiety and depression symptoms, and physical pain. Social support correlated with better quality of life and lower anxiety and depression symptoms, while resilient coping and strength/flexibility activities predicted better quality of life.

This study identified protective factors associated with favorable functional outcomes, providing insights to support psychology doctoral students during the pandemic.

Professional identity formation in medical students is a multifactorial phenomenon in which clinical and nonclinical experiences merge with individual values, beliefs, and obligations. Although a strong professional identity has been associated with career success, a mismatch between personal orientations and expectations of the profession can create anxiety and feelings of inadequacy. Evidence exists of a possible association between professional identity and mental health or burnout in medical students. Nevertheless, literature on this topic is scant and high-quality studies are lacking. Thus, the current study examined whether medical students' professional identity is associated with mental health and burnout.

This cross-sectional study used data from the ETMED-L (Etudiants de Medécine-Lausanne) project collected between November 1 and December 2, 2021. All medical students at University of Lausanne across all study years were asked to complete validated questionnaires measuring professional identity, mental health (depressive symptoms, suicidal ideation, anxiety, and stress), and burnout (emotional exhaustion, cynicism, and academic efficacy).

In total, 1,033 medical students were included in the study. Professional identity was significantly and inversely related to depressive symptoms (r = -0.30), suicidal ideation (r = -0.34), and anxiety (r = -0.30). Professional identity was also significantly and inversely related to burnout: emotional exhaustion (r = -0.33), cynicism (r = -0.51), and academic efficacy (r = 0.45 [reversed dimension of burnout]). No significant differences in professional identity scores were observed between curriculum years.

Medical students displaying higher professional identity also reported significantly fewer mental health issues and less burnout. Even though the cross-sectional design precludes any causal affirmation, the results suggest that high levels of professional identity may protect medical students against mental health issues and burnout. This study further warrants a multidimensional approach of professional identity to better capture its potential changes over time in future longitudinal studies.