Growing evidence suggests that adverse childhood experiences (ACE) increase the risk for reproductive mood disorders (RMD), i.e. premenstrual syndrome, premenstrual dysphoric disorder, postpartum and perimenopausal depression, and might be associated with symptom severity in these disorders. However, evidence for the specific impact of ACE subtypes remains scarce. This review investigates whether certain ACE subtypes are more prevalent among women with RMDs, whether women exposed to ACE have a higher risk to develop such disorders and if the degree of exposure is associated with the symptom severity. We conducted a literature search across electronic data bases and reviewed a final selection of 16 studies that differentiated between ACE subtypes. The findings indicate that emotional abuse tends to be the subtype most clearly associated with these disorders. While emotional abuse was consistently linked to adverse outcomes, the complexities of ACE co-occurrence and the potential differing impacts of other subtypes such as different forms of abuse and neglect are underscored. The review highlights the variability in study populations, methodologies, and assessment tools. The interplay between hormonal fluctuations and emotional dysregulation is discussed as potential mediators in the development of RMDs, suggesting that emotional abuse may exacerbate sensitivity to hormonal changes. Future research is called for to clarify subtype-specific mechanisms, age-related effects, and genetic predispositions to hormonal sensitivity following ACE. Overall, this article contributes to the understanding of how ACE subtypes intersect with the etiology of RMDs in women, emphasizing the need for tailored approaches in research and clinical interventions.
This review aims to report the recent advances for eating disorder focused family therapy (FT-ED) for Autistic children and young people, including outcomes, experiences, and suggested adaptations. Quantitative studies suggest that Autistic children and young people (and those with high autistic traits) receiving outpatient FT-ED are more likely to require escalation to more intensive levels of care compared to non-autistic peers. Qualitative research shows that Autistic young people and their parents/carers often report poor experiences of FT-ED. Clinicians report a lack of confidence, particularly when adapting care from a manualised approach. Commonly suggested adaptations include environmental adjustments (e.g., quiet spaces, dimmed lights), sensory-informed understanding of food and eating preferences (e.g., accounting for historical eating behaviour), communication adaptations (e.g., passports and clear, literal language), psychoeducation on autism and eating disorders, careful consideration of externalization, and use of separated sessions. Given that Autistic children and young people and their parents report poorer experiences of FT-ED relative to their non-autistic peers, adaptations that accommodate autistic needs while not interfering with ED recovery should be considered. Further development of guidelines and decision-making tools may support FT-ED clinicians to deliver effective and inclusive care.
Recurrent deliberate foreign body ingestion (DFBI) is a high-risk, resource-intensive behavior most often associated with underlying psychiatric conditions. Although medical and surgical complications are well documented, the psychiatric drivers and optimal management of DFBI are less well characterized. This review synthesizes current evidence on the epidemiology, psychiatric comorbidities, behavioral mechanisms, management strategies, and ethical challenges associated with DFBI [1, 2, 4, 6]. Recent work highlights the roles of emotion dysregulation, personality pathology—particularly borderline personality disorder—and reinforcement mechanisms in perpetuating recurrent ingestion [1, 3, 10]. A small subset of individuals accounts for a disproportionate share of hospitalizations, underscoring the chronic and relapsing nature of this behavior and its substantial healthcare costs [1, 4]. Effective care requires coordinated multidisciplinary management that integrates medical stabilization with psychiatric treatment, including structured behavioral plans, consistent team-based responses, and attention to countertransference [2, 7]. Psychotherapeutic modalities, particularly dialectical behavior therapy and borderline personality disorder–informed models, are central to long-term management, while pharmacologic interventions primarily target comorbid conditions rather than ingestion [10–12]. Ethical considerations, including assessment of decision-making capacity, perceptions of futility, and resource allocation, further complicate care [13–15]. DFBI is a complex, recurrent behavior driven by diverse psychiatric, behavioral, and systemic factors. Effective management requires coordinated multidisciplinary care that integrates medical stabilization, psychiatric treatment, structured behavioral interventions, and ethical decision-making to reduce recurrence and improve outcomes.
This narrative review focuses on the relationship between perceived family support and suicide risk in adolescence (10–19 years, with some evidence extending into young adulthood), emphasizing the role of family support as a buffer against stressful life events. Suicide and suicidal behavior among adolescents are one of the major social and health problems of the 21st century. An emerging body of studies has explored the risk and protective factors independently, but less specific research has examined how these factors relate to each other. Specifically, family support appears to be one of the most significant attenuators of suicide risk in the presence of stressful life events or adverse circumstances. It is also worth considering the possible differential effects depending on other variables such as gender or age.
Glioblastoma multiforme (GBM) is an aggressive primary brain tumor associated with poor prognosis, rapid functional decline, and psychological distress. An updated review of the literature is lacking, despite that patients with GBM appear to be among the highest risk for suicide among cancer patients. This review summarizes up-to-date evidence of suicide risk factors, screening approaches, and suicide mitigation strategies in patients with GBM. Suicide risk is the highest in the first year following GBM diagnosis. It is also associated with older age, male gender, and tumor-related factors such as supratentorial location. Other factors such as neurocognitive decline and poor functional status may also contribute. Evidence emerging from broader oncology populations suggests that demoralization and existential distress may be factors, though these have not been studied in GBM cohorts. Treatment-related psychiatric adverse effects from corticosteroids, anti-epileptic drugs, chemotherapy, and radiotherapy may also influence psychiatric illness and mediate suicide risk. Screening tools such as the Patient Health Questionnaire-9, Hospital Anxiety and Depression Scale, and Colombia-Suicide Severity Rating Scale have been effectively used to screen for suicide in conjunction with clinical interviewing in GBM patients. Evidence-based suicide reduction interventions include psychotherapy, safety planning, lethal means restriction, and caregiver support. GBM is a diagnosis that is associated with higher rates of suicide than almost all other cancers, and the extant literature identifies demographic and tumor features that are associated with suicide in this population. Effective interventions exist to identify and support these patients. Future studies should systematically measure risk factors identified in broader oncology populations to identify additional GBM-specific risk factors for suicide.
This review examines alcohol use among U.S. military personnel, including patterns of use across the full spectrum of consumption, including behaviors not meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for alcohol use disorder. It examines the prevalence and aspects of military life, culture, and context that may serve as important contributors to and risk factors for developing unhealthy, excessive, or disordered alcohol use. This review discusses efforts towards prevention, interventions, and policies pertaining to alcohol use in the military and identifies areas that would benefit from future research. Alcohol use remains a critical determinant of military health, operational readiness, and force lethality. While the Department of War (DoW) has invested in developing a modern framework for harm reduction, rates of binge and heavy drinking in the military continue to exceed that of civilians. Unique challenges of military life, including operational and institutional stressors, stigma and barriers to care, and factors of military social culture and context, coalesce to normalize and sustain unhealthy alcohol consumption within the force. Future efforts must focus on evaluating current interventions and tailoring evidence-based programs to address the needs of a diverse military population.
The paper reviews the integrated specialty care literature from the past 5 years, summarizes themes, and highlights next steps for continuing to move the field forward. Forty-six articles have been written on integrated specialty care in the last 5 years. People are using generic integration principles, adapting primary care models, and outlining new adaptations and frameworks for their specialty settings. Providers continue to find integration important to their practice and their professional satisfaction. Positive impacts continue to be made on patient outcomes, including prevention. There is some evidence for decreases in utilization. Barriers continue with respect to reimbursement and financial support. Integrating behavioral health (BH) into specialty care is a beneficial endeavor for providers and patients alike. New trends in integration continue to emerge as additional specialty practices integrate. Reducing financial barriers while engaging in efforts to build a competent BH workforce are imperatives.
Mental health disorders are a significant public health problem with profound impacts on individual health, communities and society. Interventional approaches are limited in both utilization and access, despite their strong evidence base in specific disorders. The objective of this review is to describe factors and challenges influencing equity in interventional psychiatry. Mental health care inequities are pervasive and persistent. For interventional psychiatry tools, even with current evidence of interventions’ cost-effectiveness, inequities in access persist based on geographic context, socioeconomic status, and race, as well as insurers’ reluctance to cover some of them. A wide range of social factors impact access and utilization of interventional psychiatry tools. To ensure parity, we need strategies to increase awareness and to address access and utilization disparities found across these interventions, in addition to keeping up-to-date mental health coverage policies based on new safety and effectiveness evidence.
We provide an update on the current psychiatric research for DBS and TMS and what the field has learned about causal circuitry implicated in anxiety and anxiety-related disorders. Recent refinement of DBS and TMS techniques have both improved their safety and efficacy as anxiety treatments and elucidated the pathological circuitry and areas causally involved in psychiatric disease. Anxiety is a debilitating hallmark of many psychiatric disorders. A significant portion of patients do not achieve sufficient benefit from psychotherapy and medication, so other therapies are being investigated. Neuromodulation, which involves targeted stimulation of neural circuitry, is FDA cleared for obsessive compulsive disorder (OCD) and depression and is an option for some patients whose anxiety have not responded to standard therapy. Over the past several years, neuromodulation protocol and technology advancements have continued to evolve the psychiatric treatment paradigm. Transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS) are two of the most extensively studied neuromodulation techniques in psychiatry.
Anxiety disorders are prevalent in children, adolescents, and young adults. As many youth either do not receive adequate intervention or do not achieve remission, prevention of anxiety disorders is a public health priority. Sleep problems are a modifiable risk factor that precedes anxiety. This systematic review includes recent pediatric sleep interventions and anxiety outcomes, and introduces anxiety sensitivity as an understudied mechanism. In 21 intervention and experimental studies, sleep intervention reduced anxiety symptoms/disorders and the onset of anxiety disorders. Three additional recent studies examined anxiety sensitivity in the relationship between sleep problems and anxiety, supporting the inclusion of anxiety sensitivity in future research studies. Sleep health is a scalable, accessible target for reducing anxiety and is an important part of pediatric anxiety prevention. Sleep treatments can be brief and implemented in psychiatric practice. Future research studies should consider anxiety sensitivity as a potential mechanism.
Neuropsychiatric symptoms including agitation, delirium, and psychosis are common in patients with primary or metastatic brain tumors and frequently necessitate antipsychotic treatment. Brain tumors create a hyperexcitable cortical environment characterized by glutamatergic excess, impaired inhibitory signaling, peritumoral edema, network disruption, and treatment-related neurotoxicity, all of which lower seizure threshold. Emerging data further implicates impaired astrocytic glutamate regulation, neuroligin-3–mediated neuron–glioma synaptic signaling, and IDH-mutant–associated oncometabolite accumulation as contributors to cortical instability. Neuropsychiatric symptoms often localize to frontal and temporal networks that are also highly epileptogenic, amplifying vulnerability. Brain tumor–related epilepsy further compounds this risk through recurrent seizures, interictal dysfunction, and antiseizure medication effects that contribute to cognitive and behavioral disturbance. In general psychiatric populations, second-generation antipsychotics have low intrinsic seizure liability. However, these data largely exclude patients with structural brain disease. In neuro-oncology, seizure risk is context-dependent and reflects the interaction of tumor biology, antiseizure medication exposure, metabolic instability, and dynamic treatment effects. Clozapine and low-potency first-generation antipsychotics confer the greatest seizure risk, whereas risperidone and aripiprazole are associated with lower risk. Commonly used antiseizure medications, particularly levetiracetam, may exacerbate irritability and behavioral dysregulation, increasing the need for antipsychotic treatment within an already unstable neurophysiologic environment. This review synthesizes evidence on tumor-associated hyperexcitability, antipsychotic-specific seizure liability, and clinical modifiers of risk in brain tumor populations. We propose a seizure-informed, interdisciplinary framework that integrates tumor biology, antiseizure medication selection, and psychiatric indication to guide antipsychotic prescribing in neuro-oncology.
The Far East is highly vulnerable to natural disasters and mass trauma, underscoring the critical need for child and adolescent psychiatrists (CAPs) equipped to deliver disaster mental health care. To understand regional capacity and preparedness, we conducted the third wave of a 12-year longitudinal survey tracking CAP postgraduate training systems and workforce trends in the Far East. In 2024, representatives from 16 of 17 countries and functionally self-governing areas completed a standardized online questionnaire. Data regarding CAP training structures, specialty recognition, and workforce size were descriptively compared with previous survey waves (2012 and 2017). The CAP workforce has steadily increased, with new specialists emerging in Cambodia, Mongolia, and Myanmar. By 2024, 75
Involuntary celibacy, as expressed in the contemporary online incel community, has evolved from a marginal sexual condition first studied in the late 1990s to a male-dominated digital subculture that intersects with mental health, gender-based violence, and democratic security agendas. This critical narrative review synthesizes peer-reviewed empirical and conceptual literature published primarily between 2020 and 2026 on the demographics, psychological profile, ideological architecture, online radicalization pathways, violence risk, and public health implications of the incel phenomenon. Self-identified incels show severe mental health burdens, including elevated depression, anxiety, loneliness, suicidal ideation, autism spectrum traits, and disengagement from education and employment. The “black pill” worldview that organizes much of incel discourse is based on biological determinism, lookism, and hypergamy claims, producing hopelessness and displaced rage. Pathway analyses indicate that mental health distress and ideological adherence each predict harmful attitudes more strongly than online networking, with both factors operating bidirectionally. The empirical relationship between incel ideology and outward-directed violence is contested, while the connection to self-directed violence is well supported. An adequate response to the incel phenomenon refuses both pure securitization and pure pathologization, integrating clinical engagement, education policy, platform governance, gender justice frameworks, and suicide prevention. Cross-cultural research, particularly in Southeast Asian and other Global South contexts, remains a research priority of the highest order.
This paper examines several methods of technology that have challenged traditional expectations of the meaning of psychotherapy, from the widespread adoption of telepsychiatry to the subsequent emergence of AI-driven therapeutic agents (Therabots). Widespread usage of new technology that impacts the therapeutic process has outpaced an analysis of how that technology might affect the meaning and effectiveness of that process. Lawsuits assume such technology causes harm, while limited data and the literature has been more mixed. From Frankenstein to CRISPR, new technology always has its cheerleaders and its detractors. The more the technology seems to impact a topic especially connected to our humanity, the deeper the convictions will be on both sides. Certainly, when it comes to psychotherapy, the introduction of new technologies such as telepsychiatry to Therabots has provoked discussion. We argue that while new technologies offer practical advantages, they risk functioning as structural defenses against the vulnerability and authentic intimacy essential to transformative psychotherapy. Through analysis of the therapeutic alliance, relational dynamics, and the psychology of vulnerability, this paper contends that the structural form of telepsychiatry does not alter the inherent nature of the therapeutic experience, whereas AI-mediated therapy may collude with maladaptive defenses, fundamentally altering the nature of the therapeutic encounter.
This narrative review synthesizes findings from U.S.-based peer-reviewed studies published between January 2020 and May 2025 on peer and non-specialist delivered perinatal mental health support programs for racially, ethnically and culturally diverse populations. Eight quantitative studies demonstrated improvements in depression, anxiety, and parenting outcomes through mechanisms including behavioral activation, cognitive behavior therapy, increased social support, and self-efficacy. Structured peer and non-specialist delivered programs, emphasized social support and culturally resonant approaches, with higher session “dose” linked to grater improvement in mental health outcomes. Trauma-informed models and multi-component interventions integrating culturally adapted cognitive behavior therapy and navigation also reported positive outcomes. Qualitative findings reinforced these mechanisms, with participants highlighting the importance of cultural resonance, trust, and emotional connection. However, no studies conducted formal mediation analyses. Peer‑ and non‑specialist‑delivered perinatal mental health supports show promise in improving outcomes among racially, ethnically, and culturally diverse populations in the U.S. These models draw on behavioral, psychosocial, and relational approaches, however more research is needed to establish effectiveness, guide dissemination, and identify mechanisms of change. Implementation science is critical for advancing scalable models of training and supervision, while policy innovation is needed to create sustainable funding and reimbursement pathways to embed these roles into routine perinatal care. Future efforts should intentionally employ participatory research approaches, ensure cultural relevance, and strengthen partnerships with community‑based organizations to support implementation and maximize equity, feasibility and acceptability.
To map international models of psychosocial preparedness for disasters and identify recurrent public mental health priorities for policy, service readiness, and implementation. Following PRISMA extension for scoping reviews (PRISMA-ScR) and Joanna Briggs Institute guidance, we searched PubMed (2015–2025) using two complementary strategies and mapped 35 included studies. Eight model families emerged, including community resilience and governance; non-specialist support and psychological first aid (PFA); integrated mental health and psychosocial support (MHPSS) across the disaster cycle; implementation and scale-up models; organizational and health-system preparedness; digital continuity models; monitoring and evaluation frameworks; and behavioral emergency response models. Across model families, preparedness was concentrated mainly on community and non-specialist levels, and emphasized trust, community capacity, task-sharing, workforce readiness, and continuity of care. The mapped literature supports psychosocial preparedness as a layered public health function rather than a post-event specialist intervention. Core priorities include pre-event governance, community engagement, supervised non-specialist delivery with referral pathways, workforce protection, digital continuity with clinical safeguards, and minimum monitoring standards. Future work should prioritize implementation-focused research and outcome evaluation across diverse disaster settings.
This review explores the rapidly evolving integration of Generative Artificial Intelligence (GenAI) in mental health care. It aims to evaluate current applications in assessment, treatment planning, and psychotherapeutic interventions, while critically examining the clinical risks, ethical dilemmas, and the future potential of GenAI as an adjunctive tool rather than a replacement for human-delivered therapy. Recent studies indicate that AI models can effectively assist in diagnostic reasoning, biomarker identification via EEG, and the prediction of symptom trajectories from session transcripts. Randomized controlled trials (RCTs) suggest that GenAI chatbots significantly reduce anxiety and depressive symptoms in the short term, particularly in settings with limited access to clinicians. However, human-led therapy remains superior in fostering deep emotional engagement and clinical impact. Significant risks identified include the potential for GenAI to foster dependency, reinforce maladaptive schemas or delusional ideation through “sycophantic” mirroring, and raise complex ethical-legal challenges regarding the reporting of criminal disclosures. AI represents a transformative adjunctive layer in mental health, offering scalable support for assessment, training, and between-session monitoring. While technological advances in personalization, multimodality, and immersive virtual reality enhance its clinical utility, GenAI lacks the authentic relational depth and"calibrated mismatches" essential for autonomy and transformative change. Future integration must prioritize a human-centered, blended approach, where GenAI is strictly supervised by clinicians within a robust ethical and regulatory framework to preserve the essential heart of the therapeutic connection. Research priorities, interim clinical safeguards, and recommendations for navigating the gap between current evidence and real-world adoption need to be defined and implemented.
This scoping review synthesises existing evidence from systematic reviews on the effectiveness and implementation of digital mental health interventions among community-dwelling older adults. Twenty-one systematic reviews were included. Results showed that a range of digital tools demonstrate potential to improve common mental health and psychosocial symptoms among older adults, with most evidence concentrating on digital tools to improve depressive symptoms. However, reviews’ findings were frequently mixed and accompanied with cautions that primary evidence under-reported key elements such as theoretical underpinnings, intervention design process, participant demographics, intervention acceptability and usability, participant retention, adverse events, and long-term outcomes. More rigorous research and reporting are needed to understand the mechanisms underpinning effective digital mental health interventions for older adults and how they might mitigate the age-related digital divide in mental health services.
The present narrative review synthesizes existing research on non-suicidal self-injury among Indian college students examining its prevalence, forms, repetition, impact, reasons and functions for engagement, and suggested intervention approaches as well as future research directions, while highlighting underexploration and limitations. This review synthesized 11 research which consistently showed that Indian college students engaged in non-suicidal self-injury at a concerning rate using multiple forms, such as cutting, scratching, and burning skin, while emotion regulation, interpersonal distress, self-punishment, attention-seeking, and using non-suicidal self-injury as a coping mechanism emerged as reasons. Findings also suggested multi-level and socio-ecological intervention approaches. However, the literature remains limited in exploring non-suicidal self-injury with regard to its repetition, broader impact, cultural-specific assessment, and the empirical evaluation of intervention approaches in Indian college settings. Non-Suicidal Self-Injury is a prevalent mental-health concern in Indian college settings but remains underexplored. Future research on non-suicidal self-injury in Indian college settings may be longitudinal, span across wider regions and socio-cultural backgrounds, develop cultural-specific assessments, and evaluate intervention approaches.
This systematic review and meta-analysis evaluated the effects of pharmacological and psychological treatments on depressive symptoms in individuals with body dysmorphic disorder (BDD). The primary objective was to assess treatment-related changes in depressive symptom severity among patients with BDD, while evidence regarding dysmorphic symptoms and combined interventions was reviewed narratively and should be interpreted with caution. Across 46 studies (N = 2,227), evidence suggests antidepressants—especially SSRIs—substantially reduce depressive symptoms. Cognitive-behavioral therapy (CBT) also shows large effects, though variability across trials remains high. Most research includes small samples and heterogeneous designs, underscoring the need for consistency. Pharmacological treatment yielded a pooled standardized mean difference (SMD) of −0.96 (95
