For nearly three decades, the Brain Disease Model of Addiction (BDMA) has strongly influenced scientific, clinical, and public understandings of addiction while remaining the focus of sustained debate. This critical narrative review reassesses the BDMA by integrating evidence from addiction neuroscience, genetics, neuroimaging, behavioural economics, recovery research, stigma studies, and philosophical critique. The review examines evidence supporting a neurobiological basis for addiction alongside concerns regarding causation, agency, responsibility, social context, treatment implications, and stigma. The synthesis indicates that much of the continuing disagreement reflects differing definitions of “brain disease” rather than wholly incompatible evidence. Neurobiological findings demonstrate consistent involvement of reward, motivation, learning, and control systems, but they do not by themselves establish that addiction can be fully explained at a biological level. Conversely, psychosocial and choice-based accounts do not negate the relevance of neurobiological mechanisms. The reviewed literature therefore supports an integrative interpretation in which addiction emerges from interactions among biological vulnerability, learning history, socioeconomic conditions, environmental contingencies, and individual agency. This perspective has practical implications for prevention and treatment, favouring approaches that combine mechanism-specific and precision-oriented interventions with psychosocial support, recovery resources, and attention to stigma and social disadvantage. The review concludes that future progress depends less on defending a single explanatory label than on clarifying the meaning and limits of the brain-disease concept and applying multiple levels of explanation to research, clinical care, and public health.
The amygdala, a major limbic structure, regulates emotional response, anxiety, and memory formation. Methamphetamine is known to trigger oxidative stress and neurodegeneration, whereas vitamin A possesses potent antioxidant properties that may offer neuroprotection. This study evaluated the effect of high-dose vitamin A on the amygdala of adult male Wistar rats exposed to toxic doses of methamphetamine. Twenty (20) adults male Wistar rats were randomly assigned into four groups and received as follows: Group A (control), Group B (METH-only; 5 mg/kg at 3-hours interval within 12 hours in a day), group C (Vitamin A-only; 2.5 mg/kg), while, group D (combined METH 5 mg/kg at 3-hours interval within 12 hours in a day + Vitamin A-only; 2.5 mg/kg). All experimental groups received feed and water. The administration was done orally using intubation method for a period of twenty-eight days. Body weight result revealed a significant reduction in the methamphetamine-only group compared with the control suggesting metabolic disturbance and appetite suppression. Co-treatment with vitamin A improved body weight, indicating a restorative metabolic effect. Biochemical findings showed elevated malondialdehyde (MDA) and decreased glutathione (GSH) and superoxide dismutase (SOD) levels in the methamphetamine group, confirming oxidative damage within the amygdala. Vitamin A treatment markedly reduced MDA and preserved GSH and SOD activities, demonstrating enhanced antioxidant defense. Behavioral testing using the Elevated Plus Maze indicated anxiety-related alterations following methamphetamine exposure, while vitamin A co-administration protected these behavioral changes. Histological results showed that methamphetamine caused neuronal degeneration, vacuolation, and necrosis, whereas vitamin A preserved neuronal integrity and promoted partial structural recovery. In conclusion, high-dose vitamin A significantly mitigated methamphetamine-induced oxidative and structural damage in the amygdala, highlighting its antioxidative and neuroprotective potential against psychostimulant toxicity.
Background: Internet Gaming Disorder (IGD) is an emerging behavioural health concern globally, yet its association with sleep quality among medical residents in Saudi Arabia remains understudied. Objectives: This study aimed to estimate the prevalence of IGD, assess sleep quality, and identify associated sociodemographic and lifestyle factors among medical residents in the Eastern Province of Saudi Arabia. Methods: A cross-sectional survey was conducted using a convenience sample of 292 medical residents. Validated instruments included the Internet Gaming Disorder (IGD-20) questionnaire to assess gaming behaviour and the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. Data were analysed using SPSS version 26, with statistical significance set at *p* < 0.05. Results: Among the 292 participants, 167 (57.2%) played online games, and the prevalence of disordered online gaming (IGD-20 cut-off ≥71) among gamers was 20.4% (n = 34). More than half of the total sample (55.5%) exhibited disturbed sleep (global PSQI score >5). Disordered online gaming was significantly associated with poorer subjective sleep quality (*p* = 0.006) and greater use of sleep medication (*p* = 0.005). The IGD-20 total score correlated positively with the global PSQI score (*r* = 0.268, *p* < 0.001), subjective sleep quality (*r* = 0.265, *p* = 0.001), and sleep disturbance (*r* = 0.202, *p* = 0.009). Playing online games was significantly associated with age (*p* = 0.002), gender (*p* < 0.001), marital status (*p* < 0.001), parenthood (*p* = 0.001), and caffeine consumption (*p* = 0.039). IGD-20 category was significantly associated with gaming duration on weekdays (*p* = 0.002) and weekends (*p* = 0.005). Conclusion: IGD was prevalent among medical residents in the Eastern Province and was significantly associated with poorer subjective sleep quality and greater use of sleep medication. These findings support consideration of targeted screening, awareness, and sleep-health education for residents, particularly those reporting prolonged gaming. However, causal inference is limited by the cross-sectional design and convenience sampling.
Background: Schizophrenia is frequently accompanied by substance use disorders, which complicate clinical management and contribute to recurrent hospitalisation. Evidence regarding the association between substance use disorders and 30-day hospital readmission remains inconsistent. Objective: To examine the association between substance use disorder (SUD) and 30-day hospital readmission among adults hospitalised with schizophrenia. Methods: This retrospective cohort study used version 3.1 of the Medical Information Mart for Intensive Care IV (MIMIC-IV). Adults with schizophrenia were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), and Tenth Revision, Clinical Modification (ICD-10-CM), diagnosis codes. Substance use disorder was the primary exposure, and 30-day all-cause hospital readmission was the primary outcome. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) after adjustment for age, sex, race or ethnicity, insurance type, Charlson Comorbidity Index, hospital length of stay, and discharge location. Results: A total of 7,968 eligible hospital admissions were included, of which 2,728 (34.2%) had substance use disorder and 2,461 (30.9%) experienced a 30-day readmission. After adjustment, substance use disorder was associated with lower odds of 30-day readmission (aOR, 0.85; 95% CI, 0.76 to 0.95; p = 0.004). Higher Charlson Comorbidity Index scores were associated with increased odds of readmission (aOR, 1.06; 95% CI, 1.03 to 1.09; p < 0.001), whereas discharge to a psychiatric facility was associated with markedly higher odds of readmission than discharge to home (aOR, 5.95; 95% CI, 4.72 to 7.50; p < 0.001). Conclusions: Substance use disorder was associated with lower adjusted odds of 30-day hospital readmission among adults hospitalised with schizophrenia. Patient characteristics, comorbidity burden, insurance type, and discharge destination were also associated with readmission, highlighting the importance of comprehensive discharge planning and continued follow-up. Additional multicentre studies are needed to examine clinical and social factors that may influence readmission after hospitalisation for schizophrenia.
Aim: This study aimed to determine the impact of social support networks on recovery from depression among patients with depression residing in Ikpoba-Okha LGA, Benin City, Edo State. Methods: A descriptive cross-sectional survey design was adopted to examine the relationship between social support networks and recovery from depression among adults in Ikpoba-Okha Local Government Area, Edo State. A total of 200 clinically diagnosed patients with depression were selected through simple random sampling from a population of 450 patients. Data were collected using a structured, validated questionnaire and analysed using descriptive statistics and the chi-square test at a 5% level of significance. Results: Family members, healthcare professionals and religious institutions were the major sources of social support. Social support positively influenced emotional well-being, treatment adherence, confidence and recovery, while community support was relatively low. Major barriers to accessing support included misconceptions about depression, financial constraints, inability to afford medication and stigma. A significant relationship was found between social support and recovery from depression (χ² = 24.56, df = 4, p < 0.001), indicating that stronger social support networks enhance recovery outcomes. Conclusion: The study concludes that strong family, healthcare and religious support significantly enhance recovery from depression, while stigma, financial challenges, limited community support and cultural misconceptions hinder recovery, underscoring the need for comprehensive psychosocial and community-based interventions alongside medical treatment.
One of the most prevalent mental illnesses worldwide is anxiety, with a particularly high prevalence observed among working adults. Gender plays a vital role in the prevalence, manifestation, and effects of workplace-related anxiety, yet systematic studies that disaggregate findings by gender remain limited. This systematic review compares existing empirical evidence on gender disparities in anxiety among working adults (published between 2000 and 2025), focusing on prevalence rates, workplace-related risk factors, and the extent to which gender moderates or mediates these relationships. The selected quantitative observational studies were reviewed based on PRISMA 2020 guidelines and a PICOS-based eligibility framework, covering diverse occupational sectors and countries. Findings indicates that the anxiety was consistently higher among women, ranging approximately from 25% to 40% across included studies, compared to 20% to 35% among men. Significant workplace stressors associated with anxiety include shift work, high job demands and work–family conflict were constantly associated with augmented anxiety levels. In several studies, gender moderated or mediated the association between these stressors and anxiety due to both biological susceptibility and socio-cultural expectations. The overall risk of bias ranged from low to moderate. This review highlights the necessity of developing gender-sensitive workplace mental health policies, prioritizing at-risk groups, and conducting further research that considers gender as a dynamic variable. These findings have important implications for organizational leadership, HR policies, and global occupational health strategies.
Background: Mental health disorders are a growing global crisis, disproportionately affecting vulnerable populations with limited access to care. In Zambia, services remain predominantly biomedical, under-resourced, and lacking formalized psychosocial interventions. Support groups, grounded in group psychotherapy and peer support theory, have shown promise in reducing symptom severity and improving quality of life. Aim: This study examined the effectiveness of mental health support groups on clinical and functional outcomes within this context. Methods and Materials: A prospective cohort study design was used to examine the effectiveness of mental health support groups. A total of 263 participants from 21 groups were assessed at baseline and nine months using the alcohol use disorder identification test (AUDIT), Patient health questionnaire 9 items (PHQ-9), and world health organization quality of life brief (WHOQOL-BREF). Non-parametric analyses and regression models were applied to evaluate changes in symptom severity and predictors of wellness outcomes. Results: Symptom severity significantly decreased from baseline (M = 3.992, SD = 0.829) to follow-up (M = 2.209, SD = 1.691), with a large effect size (rrb = .888). Attendance correlated weakly but significantly with symptom reduction, while facilitator type showed minor associations with quality of life (p = 0.05). Regression analysis identified symptom severity at follow-up as the strongest predictor of wellness outcomes. Structured support groups demonstrated therapeutic value in reducing distress and enhancing coping. Conclusion: Findings highlight the need for tailored interventions for individuals with persistent high severity and suggest that integrating support groups into primary care could strengthen Zambia’s mental health system, reduce stigma, and expand access to psychosocial support.
Background: Maternal mental health remains an under‑researched area in Zambia, with postpartum psychosis (PPP) representing the most severe but least documented psychiatric emergency among postnatal mothers. This study investigated the prevalence and antecedents of postpartum psychosis among postnatal mothers in Lusaka’s first‑level hospitals. Methods: Guided by the Health Belief Model (HBM), the research adopted convergent parallel mixed methods research design cross-sectionally. The study population comprised 398 postnatal mothers above 2 weeks postpartum and attended to a questionnaire that integrated the Choongo Postpartum Psychosis Scale (CPPS-8) while qualitative insights came through interviews conducted on 22 family and healthcare workers. Results: Results revealed that 23% of mothers screened positive for PPP, a prevalence substantially higher than global estimates of 1 – 2 per 1000. Key antecedents included substance use (38%), prior psychiatric history (32%), and family history of mental illness (12%). Substance use emerged as the strongest predictor (Estimate = 4.27, Wald χ² = 35.33, p < .001), with mothers engaging in alcohol or tobacco use being over three times more likely to screen positive. Regression analyses showed psychosocial and clinical factors explained up to 61% of variance in PPP screening outcomes, while demographic variables were weak predictors. Conclusion: PPP, though rare, poses significant risks to maternal and infant wellbeing if undetected. PPP is a significant maternal health challenge in Zambia, shaped by psychosocial vulnerabilities and systemic gaps. Strengthening screening, training, and community sensitization is essential to safeguard maternal and infant wellbeing.
Aims: The study aimed to investigate the demographic distribution of patients diagnosed with dementia from the Federal Neuro-psychiatric Hospital (2011-2021), Calabar, Cross River State. Study design: The retrospective research design was adopted for the study. This was done to review the records of patients who were diagnosed with dementia in Federal Neuro-psychiatric Hospital, Calabar, Cross River State. Place and Duration of Study: Federal Neuro-psychiatric Hospital, Calabar, Cross River State from 2011 to 2021. Methodology: A total of 195 medical records of patients diagnosed with dementia who had attended the Federal Neuro-psychiatric Hospital, Calabar, Cross River State from January 2011 to December 2021 were retrieved and used for the study. The instrument for primary data collection was a validated checklist designed to retrieve data on: Section A: socio-demographic data of subjects and Section B: the prevalence of dementia in Federal Neuro-psychiatric Hospital. Stratified analyses by age, gender, state of origin and type of dementia were performed to assess dementia risk at the facility. Data were analyzed using descriptive statistics and SPSS version 26. The 95% confidence interval was considered significant. Results: A higher proportion of female dementia cases was observed, 110 (56.4%) compared to males, 85 (43.6%) at the Federal Neuro-psychiatric Hospital from 2011-2021. The age range of patients with the highest percentage of dementia was between 65 and 74 (44.6%) and the lowest was between 94 years and above (11.2%). The patients from Cross River State had the highest percentage, 103 (52.8%) while those from Anambra and Imo states had the lowest percentage (1.1%). Three types of dementia were observed at the facility - Alzheimer’s disease, 113 (57.9%), vascular dementia, 28 (14.4%) and mixed dementia, 54 (27.7%). This revealed that Alzheimer’s disease was predominant compared to the other sub-types of dementia. Conclusion: The study showed that females were more predisposed to dementia than males within the Cross River population of Nigeria.
Background: Even though adolescents in Nigeria are increasingly using technology and internet-based devices, there is still a severe lack of research on cyberbullying and its possible effects on Nigerian students. Aim of the study: This study investigates the prevalence of cyberbullying involvement and its predictive influence on psychological distress (PD) among in-school adolescents in Ogun State. The Online Disinhibition Theory explains how the anonymous and minimally supervised nature of cyberspace reduces inhibition and encourages cyberbullying behaviors, while the General Strain Theory explains how experiences of cyberbullying victimization may lead to psychological distress and deviant coping behaviors such as cyberbullying perpetration. Design of the Study: Using a cross-sectional research design, Participants were selected from two public and two private secondary schools located in Obafemi Owode Local Government Area, Ogun State, South-western Nigerian. A total of 355 participants (118 male and 237 female) whose ages ranged from 13 to 19 years (mean age 15.18±1.35) were sampled using a multi-stage procedure. Tools of the Study: Participants responded to the Cyberbullying and Online Aggression Survey (CBOAS) and General Health Questionnaire 12 (GHQ-12). Descriptive and inferential statistics were used in data analysis. Results: A high prevalence of cyberbullying involvement was found. The findings showed that 33.2%, 37.5%, and 13.0% of the participants reporting mild, moderate, and severe levels, respectively. 13.0% of severe psychological distress was also reported. A significant relationship between cyberbullying involvement and psychological distress (r = .13, p < 0.05) was also found. Cyberbullying victimization and perpetration independently and jointly predicted psychological distress (F = 3.56, p < 0.05, R² = .02). Finally, significant gender influence on psychological distress was found (t (353) = 9.07, p < .01). Conclusion & Recommendations: Authors conclude that that there is a high prevalence of PD among Nigerian in-school adolescents. In addition, that cyberbullying involvement is strongly linked with PD. Based on the findings of this study, there is a need for the provision of psychological services and personnel in all secondary schools in Ogun State to reduce the prevalence of cyberbullying and its related negative consequences, as cyberbullying involvement was found to be prevalent among secondary school students in Ogun State. Further study on cyberbullying involvement and PD is also recommended.
Background: The COVID-19 pandemic accelerated the digital transformation of mental health and rehabilitation counseling services in the United States. This shift has expanded access to care, but it has also exposed persistent inequities that affect underserved populations. Objective: This scoping review maps policy pathways for equitable and culturally responsive mental-health support within digital rehabilitation counseling, and quantifies the evidence base supporting reform. Methods: Using the Arksey and O'Malley framework and the PRISMA Extension for Scoping Reviews (PRISMA-ScR), we identified, screened, and synthesized 88 sources published between 2020 and 2026 from PubMed, PsycINFO, Scopus, Google Scholar, and grey-literature repositories (WHO, FCC, HRSA, OECD, UNDP, NRHA). Descriptive statistics summarized source characteristics, a thematic coding matrix mapped eight policy-relevant themes, and a Pearson chi-square test examined associations between source type and thematic focus. Results: Most sources (84.1%, n = 74) were peer-reviewed journal articles, and 10.2% (n = 9) were institutional or governmental reports; the remainder were preprints, textbooks, or news commentaries. Ninety-six percent of dated sources appeared in 2022 or later, with a median publication year of 2025. The most frequently addressed themes were tele-rehabilitation and telehealth (27.3%), AI and digital mental health (20.5%), disability and rehabilitation (15.9%), and digital equity (14.8%). Source type and dominant theme were significantly associated (χ²(8) = 18.42, p = .018): institutional reports clustered around digital-equity and workforce issues, while peer-reviewed studies emphasized clinical and AI-related questions. Conclusions: The evidence base for digital rehabilitation counseling is growing rapidly but remains unevenly distributed across equity-critical themes. Sustainable reform calls for coordinated investment in broadband infrastructure, multilingual and disability-inclusive platform design, culturally responsive workforce development, ethical AI governance, and inclusive workforce reintegration, anchored in a “human-in-the-loop” model of care.
The medical field is among the most demanding work fields, with healthcare providers being frequently exposed to traumatic injuries, heavy workloads, and intense emotional pressures. These conditions increase the risk of developing compassion fatigue, a syndrome of physical, emotional, and psychological exhaustion resulting from sustained exposure to patients’ trauma and suffering. Although compassion fatigue has gained recognition globally, limited literature exists in Africa, particularly in Zambia. This study investigated the precursors and prevalence of compassion fatigue among healthcare providers at Levy Mwanawasa University Teaching Hospital in Lusaka. A descriptive cross-sectional quantitative design, was employed, using an online questionnaire completed by 232 healthcare professionals across 6 hospital departments. Findings showed that 59.05% of the respondents identified excessive workload as primary precursor of compassion fatigue while 11.21% cited constant exhaustion. Exposure to wounds and patients suffering was noted among 8.19% of respondents respectively. Compassion fatigue prevalence was assessed using the Professional Quality of Life (ProQOL) scale, focusing on burnout as a key indicator. Results showed that 45.26% of the respondents experienced average burnout, 31.03% low burnout, and 23.71% high burnout. Coping mechanisms included adequate rest (70.60%), shared workload, recreational activities, family support and spiritual practices. These findings highlight the urgent need for institutional strategies to mitigate compassion fatigue and promote healthcare professional well-being.
Burn injuries represent among the most devastating forms of physical trauma, leaving survivors to navigate complex trajectories of surgical reconstruction, functional rehabilitation, and profound psychological adaptation. This critical review examines the convergence of reconstructive surgical practice and psychological healing in burn care, synthesising evidence published between 2010 and present. The review draws on literature spanning plastic and reconstructive surgery, clinical psychology, psychiatry, rehabilitation medicine, and health-related quality of life research to interrogate how physical restoration and mental health interact, reinforce, and sometimes conflict with one another throughout the recovery continuum. Key surgical modalities—including skin grafting, flap reconstruction, tissue expansion, and laser therapies—are evaluated alongside their documented psychological correlates, with particular attention to post-traumatic stress disorder, depression, body image disturbance, and chronic pain. The review critically appraises multidisciplinary care frameworks, psychosocial screening tools validated in burn populations, and the emerging role of psychological interventions such as cognitive behavioural therapy, acceptance and commitment therapy, and virtual reality-based treatments. Disparities in access to integrated care across high-income and low- and middle-income country contexts are examined, as are special considerations pertaining to paediatric survivors and individuals with large total body surface area injuries. The evidence collectively supports the position that surgical and psychological components of burn recovery are not sequential but deeply interdependent, and that care models failing to account for this interdependence generate measurable deficits in long-term patient outcomes. The review concludes by identifying critical gaps in the literature and proposing directions for future integrated research.
Background: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline and memory impairment, representing a major global health challenge. With no definitive cure currently available, preventive strategies targeting modifiable risk factors have gained increasing attention. This study presents a systematic review of the role of physical activity in the prevention of Alzheimer’s disease, focusing on underlying biological mechanisms, epidemiological evidence, and exercise modalities. Methodology: A structured literature search was conducted across major databases, including PubMed, Web of Science, and Google Scholar, covering studies published between 2020 and 2024. Eligible studies included observational studies, randomized controlled trials, and systematic reviews examining the relationship between physical activity and cognitive outcomes. Results: Findings indicate that regular physical activity is associated with a reduced risk of Alzheimer’s disease and improved cognitive function. Mechanistically, exercise promotes neurogenesis, enhances brain-derived neurotrophic factor (BDNF) expression, improves cerebral blood flow, and reduces neuroinflammation and oxidative stress. Aerobic exercise, resistance training, and mind-body interventions all demonstrate beneficial effects, with combined exercise approaches showing the greatest impact. Conclusion: In conclusion, physical activity represents a cost-effective, accessible, and non-pharmacological strategy for reducing Alzheimer’s disease risk. Future research should focus on standardising exercise protocols and establishing causal relationships through long-term randomised trials.
Background: Depression has a substantial direct and indirect impact on physical illness among the general outpatients. This impact includes amplifying physical symptoms and worsening functional impairment, thereby increasing morbidity and mortality, decreasing patients’ adherence to treatment, increasing the cost of treatment, and reducing the health-related quality of life. Aim: This study aimed to determine and compare the prevalence and factors associated with depression amongst rural and urban general outpatients. Study Design: It was a descriptive comparative cross-sectional study. Place and Duration of Study: The study was conducted in two general out-patients clinics located in urban and rural Kano, respectively, viz. Aminu Kano Teaching Hospital (AKTH) and Kumbotso Comprehensive Community Healthcare Clinic (KCCHC). Methodology: A minimum sample size was calculated to be 50 per each group (Rural vs Urban) and 10 was added per each group to allow for attrition or non-response. A simple random sampling was employed to select 60 participants with depression. Patient Health Questionnaire 9(PHQ-9) was used to screen for depression, and was confirmed using Mini International Neuropsychiatric Inventory (MINI-5) among the participants. They were also assessed for social support using the Oslo-3-item Social Support Scale (OSS-3). Results: A higher prevalence of depression was found among urban patients (53.6%) than their rural counterparts (33%). In the urban area, depression was associated with chronic medical illness, a family history of mental illness, lower social support and lower social status. In rural areas, depression was associated with being single; increased frequency of consultation visits, fewer years in formal education and having more than one physical illness. Conclusion: Depression was more prevalent among urban outpatients than their rural counterparts. There is a need to incorporate regular screening of depression in the study areas, most notably among patients who are at high risk (Urban > rural) of depression based on the factors that were identified to be associated with depression in the study.
This study examines how school psychologist workforce capacity influences the timeliness of Autism Spectrum Disorder (ASD) diagnosis and access to intervention services within Title I schools in the United States. Using secondary data obtained from the National Center for Education Statistics (NCES), including the Common Core of Data (CCD) and EDFacts databases, the study adopts a quantitative design to investigate the direct, indirect, and contextual effects of workforce capacity on ASD service delivery outcomes. Workforce capacity was operationalized using the student-to-psychologist ratio, while early identification, intervention access, and assessment capacity were measured using standardized proportional indicators derived from school-level reporting data. The analysis integrated multivariate linear regression, binary logistic regression, mediation analysis, and hierarchical linear modeling to evaluate the relationships among workforce capacity, assessment processes, and intervention access across Title I school contexts. The findings indicate that higher psychologist-to-student ratios significantly reduce early ASD identification rates (β = -0.000185, p < 0.001) and decrease the likelihood of access to intervention services (β = -0.00112, p < 0.001). Mediation analysis further demonstrates that assessment capacity partially mediates the relationship between workforce capacity and service access, while multilevel modeling reveals that the negative effects of workforce shortages are significantly amplified in high Title I contexts (\gamma = -0.000057, p = 0.002). The study concludes that workforce shortages and structural socioeconomic disadvantage jointly constrain ASD diagnostic and intervention pathways within underserved schools. The findings highlight the importance of strengthening workforce distribution, improving assessment infrastructure, enhancing inter-agency coordination, and expanding alternative service delivery models to improve equitable access to ASD-related services.
Introduction: Off-label prescribing refers to the use of approved medications for indications, populations, dosages, or routes not formally approved by regulatory authorities. While legally permitted and often necessary in clinical practice, such use requires careful evaluation of safety and efficacy. Olanzapine, a second-generation atypical antipsychotic primarily approved for schizophrenia and bipolar I disorder, possesses a broad multi-receptor antagonism profile that may explain its increasing off-label clinical applications. Objective: To review the current evidence regarding major off-label clinical uses of olanzapine, including its mechanisms of action, therapeutic efficacy, and safety considerations. Methods: This review synthesizes findings from published literature, including randomized controlled trials, systematic reviews, meta-analyses, and observational studies evaluating off-label uses of olanzapine across different clinical conditions. Evidence was examined to identify therapeutic benefits, mechanisms of action, and reported adverse effects. Literature was sourced from databases such as PubMed, Scopus and Google Scholar. Results: Olanzapine has demonstrated significant benefit in several off-label indications. The strongest evidence exists for chemotherapy-induced nausea and vomiting (CINV), where its multi-receptor antagonism (dopamine, serotonin, histamine, muscarinic, and α-adrenergic receptors) contributes to effective antiemetic activity and has led to its inclusion in international antiemetic guidelines. Additional evidence supports its use in anorexia nervosa, where it may promote weight gain and reduce anxiety related to body image; insomnia, due to potent sedative effects mediated primarily by H1 and 5-HT2 receptor blockade and substance use disorders, where modulation of mesolimbic dopamine pathways may reduce craving and drug-seeking behaviour. Potential benefits have also been reported in pain syndromes, delirium, and anxiety-related conditions, although the strength of evidence varies and remains inconsistent in some indications. Across studies, common adverse effects include sedation and metabolic changes such as weight gain, while serious but rare events include QTc prolongation, neutropenia, and seizures. Conclusion: Olanzapine’s broad pharmacodynamic profile enables therapeutic benefits across multiple off-label indications, particularly when standard treatments fail. However, the risk of metabolic and sedative adverse effects necessitates careful patient selection and individualized risk–benefit assessment. Further large-scale randomized controlled trials are required to establish standardized dosing strategies and long-term safety for these off-label applications.
Takayasu arteritis a rare chronic granulomatous vasculitis that causes arterial stenosis, occlusion, and systemic effects, mostly affects the aorta and its primary branches. The illness, which can produce a variety of neurological and systemic symptoms, most commonly affects young women. We report a 29-year-old female patient with neurological symptoms who was diagnosed with Takayasu arteritis linked to myelin oligodendrocyte glycoprotein antibody disorder (MOGAD). The clinical evaluation's findings of hypertension, limb weakness, and neurological deficits prompted further diagnostic investigations, such as laboratory tests and cerebrospinal fluid analysis. Imaging and laboratory results supported the diagnosis of Takayasu arteritis with neurological damage. The patient was given high-dose corticosteroid therapy, antihypertensive drugs, immunomodulatory drugs, and supportive care. The patient showed clinical improvement, and their neurological problems normalized during their hospital stay. This case highlights the need to identify Takayasu arteritis early, particularly when neurological signs are present, and the importance of interdisciplinary care in improving clinical outcomes.
Adolescent mental health issues are increasing, with many students reporting sadness and anxiety. Schools can help identify early warning signs, but limited resources often delay timely support, especially in underserved areas. This study explored predictive analytics as a school-centric approach for the early detection of youth mental health risks in underserved educational settings. Grounded in ecological and risk-and-resilience frameworks, the research synthesized existing predictive models and identified key indicators such as academic performance, bullying victimization, sleep disturbances, and substance use from publicly available youth survey and school policy datasets. A modular data architecture was proposed that integrates student-level behavioral and demographic variables with school-level contextual factors, including policy strength, counselor ratios, and climate indicators. Using synthetic data derived from publicly available youth survey and school-policy indicators, penalized logistic regression, random forest, and XGBoost models were evaluated, achieving moderate discriminatory power with AUC values ranging from 0.70 to 0.75. Fairness assessments highlighted trade-offs across racial groups, emphasizing the need for equitable deployment. Ethical, privacy, and implementation guidelines were developed to support feasible adoption in low-resource schools. Results demonstrated the value of leveraging routine school data for proactive risk stratification and targeted support. The study concludes that predictive analytics offers a practical pathway to address delayed identification of internalizing symptoms while balancing accuracy, equity, and feasibility. Recommendations include real-world piloting, explainable AI integration, and stakeholder collaboration to strengthen mental health support systems in underserved schools.
Burnout among healthcare practitioners is a critical issue affecting both the workforce and the quality of patient care. It is characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, leading to decreased job satisfaction and increased turnover rates. This study aimed to assess the prevalence and related factors of burnout among healthcare practitioners at Livingstone Central Hospital in Zambia. A cross-sectional survey was conducted with 69 healthcare practitioners at Livingstone Central Hospital. The Maslach Burnout Inventory (MBI) was used to measure burnout across three dimensions: emotional exhaustion, depersonalization, and personal achievement. Socio-demographic and work-related factors were also collected. Descriptive statistics, correlation analysis, and multiple regression analysis were employed to examine the relationships between these factors and burnout. The findings revealed moderate levels of burnout. Emotional exhaustion averaged 18.2, with 16% reporting extreme fatigue. Depersonalization had a mean score of 9.8, while personal achievement was generally low, averaging 39.5, with about 61% of respondents reporting reduced accomplishment. Age, work experience, and professional role were significantly associated with burnout dimensions. Regression analysis showed that workplace comfort and functionality (β = -11.2, p < 0.001) and decision-making involvement (β = -7.5, p = 0.007) were strong protective factors, explaining about 45% of burnout variance (R² = 0.445). Organisational support for professional growth also had a significant impact, accounting for 46% of variance (R² = 0.461). Findings suggest that workplace comfort, involvement in decision-making, and organisational support for professional growth are strongly associated with lower burnout scores. These factors may serve as protective correlates rather than definitive solutions. The study underscores the need for targeted interventions and policies to support the well-being of healthcare workers and, consequently, improve the quality of patient care. The need for future research remains to solidify and expand the understanding on burnout.
