Existing research has shown that prematurity and low birth weight are associated with mental health in children and adolescents, but their impact on mental health in adulthood and the mechanisms involved have been less studied. This study investigated the impact of prematurity and abnormal fetal growth, as a marker for fetal growth restriction, on mental health outcomes in adulthood.

This retrospective cohort study examined adults aged 18-52 years, categorized by gestational age (extremely preterm: ≤28 weeks; very preterm: 29-32 weeks; moderately preterm: 33-36 weeks; term: ≥37 weeks). The cohort consists of individuals who were either born preterm or at term from 1969 to 2002. Data collection occurred between 2019 and 2021. This exploratory analysis used multivariable logistic regression to assess the impact of prematurity and fetal growth restriction on adult mental health outcomes (measured by the "Patient Health Questionnaire"), adjusting for age, gender, and socioeconomic status. The study also explored the relationship between childhood behavioral problems, retrospectively described by the mothers of the participants (2-4 years), and adult mental health, with separate analyses for preterm and term births.

The multivariable logistic regression analysis of 606 participants (average age 28·96 ± 8·9 years, 326 females) indicated that a low gestational age of ≤28 weeks was independently associated with an increased prevalence of major depressive disorder (OR = 4·14, CI: 1·43-11·77, p = 0·01) and anxiety disorder (OR = 5·17, CI: 1·51-17·37, p = 0·01) in adulthood compared to a gestational age of ≥37 weeks. A low birth weight percentile was not associated with mental disorders. Further regression analysis revealed that peer problems and emotional problems in childhood were significantly associated with major depression in adulthood in participants born preterm. The sensitivity analysis revealed that the previously observed association between the gestational age group of ≤28 weeks and major depressive disorder was no longer statistically significant (OR = 2·84, CI: 0·85-9·07, p = 0·08) when the model was adjusted for maternal smoking and alcohol consumption during pregnancy. The association between the extreme preterm group and generalized anxiety disorder remained significant (OR = 4·63, CI: 1·27-16·22, p = 0·02).

This study provides exploratory insights into the complex impact of prematurity on mental health in adulthood, highlighting the vulnerability of the extremely preterm group (≤28 weeks) from a multi-informant, lifespan perspective. It emphasizes the importance of continuous monitoring and psychosocial support for those born extremely preterm, from infancy through adulthood, to mitigate potential adverse mental health outcomes.

The Gutenberg Prematurity Study was supported by the Ernst und Berta-Grimmke Stiftung, Stufe 1 support of the UM and the Else Kröner-Fresenius-Stiftung.

The high comorbidity of major depressive disorder (MDD), anxiety disorders (ANX), and post-traumatic stress disorder (PTSD) complicates the study of their structural neural correlates, particularly in white matter (WM) alterations. Using fractional anisotropy (FA), this meta-analysis aimed to identify both unique and shared WM characteristics for these disorders by comparing them with healthy controls (HC). The aggregated sample size across studies includes 3,661 individuals diagnosed with MDD, ANX, or PTSD and 3,140 HC participants. The whole-brain analysis revealed significant FA reductions in the corpus callosum (CC) across MDD, ANX, and PTSD, suggesting a common neurostructural alteration underlying these disorders. Further pairwise comparisons highlighted disorder-specific differences: MDD patients showed reduced FA in the middle cerebellar peduncles and bilateral superior longitudinal fasciculus II relative to ANX patients and decreased FA in the CC extending to the left anterior thalamic projections (ATPs) when compared with PTSD. In contrast, PTSD patients exhibited reduced FA in the right ATPs compared to HC. No significant FA differences were observed between ANX and PTSD or between ANX and HC. These findings provide evidence for both shared and unique WM alterations in MDD, ANX, and PTSD, reflecting the neural underpinnings of the clinical characteristics that distinguish these disorders.

Safe Spaces offer a person-centred, non-clinical and welcoming place for adults experiencing a mental health crisis to seek support as an alternative to presenting to the Emergency Department (ED). The aim of the study was to evaluate the effectiveness of Queensland Health’s Crisis Support Spaces (CSS), which are a hospital-based Safe Space service that has been piloted in the state of Queensland in Australia.

The research employed a mixed-methods design. Retrospective, de-identified program data was analysed from 2,235 consumers who accessed a CSS in Queensland during the period of 23/01/2021 to 31/10/2023. Outcome variables were computed using data from Queensland Health’s Consumer Integrated Mental Health and Addiction (CIMHA) and Emergency Data Collection (EDC) datasets. Within-groups t-tests were used to analyse pre- to post- intervention changes in psychological distress ratings, number of mental health related ED presentations and number of mental health related hospital admissions. In addition, 78 semi-structured interviews were undertaken with CSS consumers and carers, CSS staff and broader mental health system staff; these were analysed using applied thematic analysis.

Consumers experienced a statistically significant, large sized reduction in psychological distress ratings at post-intervention (mean difference = -2.9; p <.001; d = 1.30). A statistically significant, large sized reduction was also observed in the number of mental health related hospital interventions at 6-months post-intervention for those consumers with a prior history of inpatient admissions (mean difference = -1.0; p <.001; d = 0.80). Furthermore, a statistically significant, small sized reduction was observed in mental health related emergency department (ED) presentations at 6-months post- intervention for those consumers with a prior history of ED presentations (mean difference = -0.8; p <.001; d = 0.37). Qualitative data provided insights into potential mechanisms through which the service may achieve its intended outcomes (e.g., providing a safe environment for consumers to de-escalate their psychological distress, teaching consumers skills to self-manage their mental health).

The findings of this study provide mixed-methods evidence supportive of the effectiveness of CSS in helping consumers reduce their psychological distress and preventing mental health related ED presentations and hospital admissions.

Pediatric hair-pulling disorder (HPD) and skin-picking disorder (SPD) are treatment-resistant conditions understudied with neuroimaging. We report cross-sectional morphometric MRI results from the adolescent-early adult subsample of the Body-Focused Precision Medicine Initiative (BPMI), a major HPD-SPD MRI database. Participants aged 11-21 years comprised 30 with HPD, 13 with SPD, 16 with both HPD and SPD, and 29 typically developing (TD). Whole-brain MRI was parcellated into cortical and subcortical regions with FreeSurfer. Volume and (for cortex) thickness and surface area of each region were analyzed for effects of HPD and SPD, controlling for psychotropic medication, age, total intracranial volume, and scanning site. Morphometry of four regions most reflected diagnosis and severity of HPD: 1) left inferior frontal cortex (larger and thicker for more severe HPD); 2) corpus callosum (larger for more severe HPD); 3) lingual gyrus (smaller right cortical surface area and white-matter volume); and 4) fusiform gyrus (smaller right cortical and white-matter volumes for more severe HPD). For SPD, there were three regions: 1) parahippocampal gyrus (larger left white matter volume and larger bilateral cortical volume and surface area for more severe SPD); 2) fusiform cortex (thicker left cortex for more severe skin-picking urgency); and 3) entorhinal cortex (thicker right cortex for more severe urgency). Variations in regional morphometry may result from or predispose to HPD and SPD. Left inferior frontal and callosal findings suggest lateralized dysfunction in HPD similar to language disorders; in SPD parahippocampal findings may indicate dysfunction in emotion regulation and/or contextual association.

This study aimed to explore the experiences of female college students with disordered eating behaviors participating in a 2-week, app-based, heart rate variability biofeedback (HRVB) intervention.

Eight female college students (M_age = 22.3 years) with disordered eating behaviors were recruited from a large public university.

As part of a larger pilot randomized controlled trial, this qualitative study used semi-structured interviews with participants to capture their perceptions of HRVB's impact on emotional and eating-related coping strategies. Thematic analysis was employed to identify emerging themes with four coders.

Three major themes emerged, including (1) the positive impact of HRVB on physical and mental health, (2) improved resiliency and positive stress adaptation, and (3) the impact of HRVB on eating behavior.

Larger, more diverse samples and longitudinal designs are recommended to further examine HRVB's potential in enhancing emotional regulation and addressing disordered eating behaviors.

Major depressive disorder (MDD) is associated with ineffective affect regulation. Vocal data can shed light on communication and expression during psychotherapy and provide high-resolution data for the study of affective arousal dynamics. Computerized vocal analyses were used to examine the extent to which intrapersonal and interpersonal vocal-arousal dynamics were linked to session outcomes and whether a session's dampening as compared to an amplification arousal trajectory would moderate this association.

Data from 30 clients treated for MDD by nine therapists were analyzed. A total of 9,324 vocal arousal data points were extracted from the working phases of 137 therapy sessions. The clients reported their well-being levels before and after each session on the Outcome Rating Scale.

Vocal-analysis revealed both intrapersonal regulation (towards one's baseline) and interpersonal regulation (towards the partner's arousal level). Only clients' interpersonal regulation towards their therapist's arousal level was linked to better session outcomes. Notably, this positive link occurred more in sessions where the client's overall arousal decreased (dampening); no such link was observed when arousal increased (amplification).

These results suggest that interpersonal (i.e., therapist-client) affect regulation may contribute to therapeutic change in sessions characterized by overall dampening in patients diagnosed with MDD.

Aim: To analyze the health status of children and adolescents depending on the severity of traumatic stress.

Materials and Methods: The study involved 105 children and adolescents (mean age [mean ± standard deviation] 11,3±2,7; 48 [45,7%] boys and 57 [54,3%] girls), who suffered to some extent from the Russian army's invasion of Ukraine. The respondents' mental and somatic states were assessed using the Child Traumatic Stress Scale - Pediatric Traumatic Stress Screening Tool (PTSST) and the Children's Somatic Symptoms Inventory (CSSI-24).

Results: According to the screening data on the PTSST, 42,9% of children presented with a moderate risk, and 40,0% with a high risk of developing post-traumatic stress reaction (PTSR) (83% in total). We revealed a trend towards an increase in the PTSST score with respect to the increase in the stress burden per participant. The PTSST score was comparable between children who remained in the fighting zone and those who left and live abroad. The CSSI-24 data suggested that 44,8% of children had somatic symptoms of high or moderate intensity. Gastrointestinal complaints were identified more often than others and had a pronounced degree of severity. A strong direct correlation was revealed between PTSST and CSSI-24 scores (ρ=0,726; p<0,05).

Conclusions: The mental state of children was characterized by the risk of developing PTSR in more than 80% of children. A strong direct correlation between the level of traumatic stress reaction and the severity of somatic complaints indicates a high risk of developing somatic diseases as a result of the stress experienced.

Hypertension is one of the most common non-communicable diseases in the world and plays a significant role in the occurrence of cardiovascular complications, including coronary heart disease (CHD) and strokes. Therefore, the purpose of this study is to conduct an economic evaluation of high blood pressure screening strategies in Iran in 2020.

We did an economic evaluation of 9 blood pressure screening strategies, including screening annually or every two or three years from the ages of 30, 40, or 50, using the Markov model. The Markov model was designed and implemented based on the natural history of cardiovascular disease in the 2020 TreeAge Pro software. The quality-adjusted life years and the average cost of high blood pressure screening and treatment per person were estimated from society's perspective for the lifetime. Input data of the model were derived from published literature, expert opinion, and available data sources.

All screening interventions were more costly and more effective compared to no screening. Five strategies, including screening every three years from the age of 50, 40, and 30 years and screening every two years and annually from the age of 30, were undominated. Incremental cost-effectiveness ratios for these strategies ranged from $PPP 2,675.20 to 20,466.83. Probabilistic sensitivity analysis indicated that, at a cost-effectiveness threshold close to one times the GDP per capita, screening every two or three years from age 30 had the highest cost-effectiveness, with probabilities of 0.522 and 0.44, respectively.

Based on the findings of the economic evaluation, all screening strategies are more cost-effective compared to no screening, and among the screening strategies, considering about one times the GDP per capita as the cost-effectiveness threshold, a screening strategy every two years, starting at the age of 30, is the most cost-effective strategy.

Letermovir (LTV) effectively prevents cytomegalovirus (CMV) reactivation in CMV-seropositive patients. To evaluate the impact of LTV in matched sibling haematopoietic stem cell transplantation (HSCT) recipients, we retrospectively compared 72 matched sibling transplantation recipients receiving LTV with 134 controls. LTV significantly reduced 200-day CMV viraemia incidence (5.6% vs. 33.3%, p < 0.001). Multivariable analysis identified anti-thymocyte globulin (ATG) use (p = 0.005) and grade III-IV acute graft-versus-host disease (aGVHD; p < 0.001) as independent risk factors for CMV viraemia, while CMV serostatus did not significantly affect CMV viraemia (p = 0.448). Stratification based on risk factors (ATG, grade III-IV aGVHD) showed that LTV had a more significant effect on high-risk patients compared to low-risk patients. Also, LTV prophylaxis was associated with increased Epstein-Barr virus (EBV) viraemia (13.9% vs. 1.4%, p = 0.025) and higher CD20 monoclonal antibody utilization (11.1% vs. 1.4%, p = 0.046). Long-term survival remained similar between both groups. Results were validated in a second cohort from our centre. In conclusion, LTV prophylaxis significantly reduced CMV viraemia, especially in high-risk patients (ATG/grade III-IV aGVHD). However, the LTV group showed an elevated risk of EBV-related complications. Risk stratification-rather than CMV serostatus alone-should guide CMV prevention strategies in matched sibling HSCT. Larger clinical studies are needed for validation.