Objective:Oxidative-antioxidant imbalance has been proposed as a biological contributor to attention-deficit/hyperactivity disorder (ADHD), yet findings across biomarkers, age groups and assay platforms remain heterogeneous. We synthesised evidence on oxidative damage markers (malondialdehyde [MDA], 8-hydroxy-2'-deoxyguanosine [8-OHdG]), global redox indices (total oxidant status [TOS], oxidative stress index [OSI], total antioxidant status [TAS]) and enzymatic antioxidants (superoxide dismutase [SOD], glutathione peroxidase [GPx], catalase [CAT]). Method:Following PRISMA 2020 guidelines, we searched major databases for studies published between 2010 and 2025. Case-control studies and baseline data from trials reporting group means and standard deviations were eligible. Standardised mean differences (Hedges' g) were pooled using random-effects models. Prespecified moderators included age group, medication status and assay or biological matrix. Results:Across fifteen case-control studies, ADHD was associated with a consistent shift towards oxidative imbalance. Oxidative damage was higher in ADHD for MDA (g = 0.32, 95% CI 0.18-0.46), 8-OHdG (g = 0.27, 0.10-0.44), TOS (g = 0.35, 0.20-0.50) and OSI (g = 0.31, 0.16-0.46). Antioxidant capacity was reduced for TAS (sign-inverted g = 0.25, 0.08-0.42) and SOD (sign-inverted g = 0.22, 0.05-0.39), whereas GPx and CAT showed no consistent differences. Heterogeneity was low to moderate, with no evidence of publication bias. Effects were larger in drug-naïve paediatric samples than in adults or treated cohorts. Conclusions:ADHD is associated with a small-to-moderate redox imbalance, most pronounced in untreated paediatric populations. These findings support oxidative-antioxidant dysregulation as a biologically meaningful dimension of ADHD and provide a framework for understanding heterogeneity in psychopharmacological response.
Objective:fibromyalgia (FM) is a chronic condition characterized by widespread pain, fatigue, sleep disturbances, and psychological distress, with a significant impact on quality of life. While cognitive-behavioral therapy has been extensively studied as a psychological intervention for FM, the effectiveness of psychodynamic interventions remains underexplored. This systematic review aims to synthesize the existing literature on psychodynamic interventions for FM, focusing on their impact on clinical and psychological outcomes. Method:a systematic search was conducted across PsycINFO, Cochrane, PubMed, and Web of Science databases. A total of six studies meeting the inclusion criteria were identified, investigating different psychodynamic approaches, including Attachment-Based Compassion Therapy, Emotional Awareness and Expression Therapy, and shortterm psychodynamic psychotherapy. Results:across these studies, psychodynamic interventions showed potential - but still preliminary - benefits, including reductions in pain severity, anxiety, depression, and psychological distress, alongside improvements in emotional functioning and quality of life. However, substantial heterogeneity across interventions, study designs, and outcome measures, combined with moderate-to-high risk of bias and the small number of available studies, limits the strength of the conclusions. Conclusions:the current evidence does not allow definitive recommendations regarding psychodynamic interventions for FM. Further methodologically rigorous research is needed to clarify the specific efficacy, generalizability, and underlying mechanisms of these interventions.
Objective:in the context of interpersonal violence, traumatic experiences are linked to both the risk of victimization and perpetration. Yet, most studies have examined these roles separately leaving unclear how traumatic experiences in the past and traumatic symptoms in the present may differently contribute to victimization vs perpetration-related problems. This study investigates if the relationships between early traumatic experiences and interpersonal problems typically associated with victim-like and offender-like roles are mediated by trauma symptoms (PTSD, DSO and Dissociation) in women. Method:ninety-eight adult women from the general population (Mage = 33.0, SD = 8.25) completed self-report measures assessing childhood trauma exposure (CTQ-SF), trauma-related symptoms according to ICD-11 criteria (ITQ; PTSD and disturbances in self-organization), dissociative symptoms (DES-II), and interpersonal functioning (IIP-32). Interpersonal risk phenotypes were operationalized as victimization-related (friendly-submissive) and perpetration-related (hostile- dominant) interpersonal problems. An overall childhood trauma severity factor was derived from CTQ clinical subscales using exploratory factor analysis. Two parallel mediation models were tested using bias-corrected bootstrap procedures, controlling for age and marital status. Results:the findings revealed that while dissociation contributes to both victimization-risk and perpetration-risk profiles, PTSD symptoms specifically foster victimization behaviors, whereas DSO symptoms are more strongly associated with perpetration behaviors. Specifically, childhood trauma was indirectly associated with victimization-related interpersonal problems through PTSD symptoms and dissociation, whereas the indirect path through DSO was not significant. Conversely, childhood trauma was indirectly associated with perpetration-related interpersonal problems through DSO symptoms and dissociation, while PTSD did not emerge as a significant mediator. In both models, direct effects of childhood trauma on interpersonal outcomes were non-significant once trauma-related symptoms were included, supporting a full mediation pattern. Conclusions:in conclusion, early adverse experiences, and trauma-related symptoms, appear to make women more vulnerable to victimization/perpetration-like problems. These results clarify distinct trauma-related pathways, underscoring the need for targeted preventive interventions.
Objective:recent years have seen considerable attention to concerns regarding youth access to screens. Many professional bodies and clinicians have advised parents to limit youth access to smartphones and tablets, particularly at young ages. However, little clear evidence has emerged to support this advice. Method:a dataset of 80,878 young adults (mean age: 23.3) was provided by Sapienlabs. Data included childhood age of first access to smartphones and tablets, as well as exposure to adverse childhood events. Relationships with current mental health were tested using OLS regression. Results:results indicated that exposure to adverse childhood events was predictive of mental health difficulties in early adulthood. Age of access to smartphones and tablets was not. Conclusions:advice to parents to avoid earlier access to smartphones and tablets appears to be unwarranted. Moral panic concerns about technology may distract society from more pressing causes of mental health difficulties such as abuse, neglect, and parental mental health.
Objective:theory of mind (ToM) impairment is a well-established feature of schizophrenia; however, the relative contribution of negative symptoms and disorganization remains unclear, particularly in clinically stable outpatients. Moreover, few studies have modeled symptom domains simultaneously while accounting for illness chronicity and antipsychotic exposure. Method:in this cross-sectional case-control study, 52 clinically stable outpatients with schizophrenia and 52 healthy controls completed the Reading the Mind in the Eyes Test (RMET). Symptom dimensions were derived from the Positive and Negative Syndrome Scale (PANSS) using a five-factor framework. Hierarchical regression analyses examined independent predictors of RMET performance within the schizophrenia group. Sensitivity analyses included illness duration, olanzapine-equivalent dose, and alternative disorganization operationalizations. Receiver operating characteristic (ROC) analysis evaluated discriminative capacity. Results:patients demonstrated significantly lower RMET scores than controls (d = -1.42, p < .001). Within the schizophrenia group, negative symptoms (β = -.33, p = .015) independently predicted RMET performance after controlling for demographic variables and disorganization. This association remained robust after adjusting for illness duration and medication dose. Disorganization showed modest bivariate associations but did not retain independent predictive value in multivariable models. RMET demonstrated good discriminative accuracy (AUC = 0.84), with high specificity at the optimal cut-off. Conclusions:ToM impairment in clinically stable schizophrenia is substantial and appears more strongly linked to negative symptom severity than to disorganization. These findings support routine assessment of social cognition in patients with prominent negative symptoms and highlight the dimensional interplay between motivational deficits and social-cognitive dysfunction.
Objective: this study, grounded in attachment theory and situated within the debate between categorical and dimensional approaches to attachment, aims to pursue two complementary objectives: firstly, to examine the differences in physical and mental health across different attachment styles; secondly, to analyze the specific contribution of internal working models (IWMs) in explaining these variations, allowing for an integrated interpretation of the results. Method: a total of 548 Italian adults participated in the study by completing selfreport questionnaires assessing the aforementioned study variables. For the first aim, univariate analyses of variance (ANOVAs) were conducted to test differences in physical and mental health according to different attachment styles; for the second aim, multiple linear regression analyses were performed by including physical and mental health as dependent variables and IWMs of the self and IWMs of others as potential explanatory variables. Results: the findings suggest that individuals with secure and dismissing attachment styles, both characterized by positive IWMs of the self, report better mental health when compared to those with preoccupied and fearful patterns, who are characterized by negative IWMs of the self. As for the second aim, IWMs of the self emerged as a substantially stronger predictor of mental health than IWMs of others. No associations were found with physical health. Conclusions: overall, the findings highlight the central role of attachment in adult mental health from an integrative perspective. While the categorical approach reveals clear differences in mental health across attachment styles, the dimensional analyses indicate that IWMs of the self constitute the primary mechanism underlying these differences. These results support the value of combining categorical and dimensional approaches to achieve a more comprehensive understanding of the relationship between attachment and health.
Objective: psoriasis is a chronic immune-mediated disease that significantly impacts patients' health-related quality of life (HRQOL). While effective treatments exist, the burden of psoriasis on HRQOL and the factors influencing it remain underexplored in Vietnam. To assess HRQOL and its associated factors among patients with psoriasis vulgaris in a tertiary hospital in Vietnam. Method: a cross-sectional study was conducted from March to December 2023, including 149 patients with psoriasis vulgaris. HRQOL was evaluated using the EQ-5D-5L tool, and disease severity was assessed with the Psoriasis Area and Severity Index (PASI). Data analysis included descriptive statistics, chi-square tests, and stepwise multivariate Tobit regression to identify factors associated with the EQ-5D index. Results: the mean EQ-5D index was 0.85 (SD = 0.17), with patients reporting the fewest problems in mobility (88.6% no issues) and self-care (81.2% no issues). However, pain/discomfort (68.5%) and anxiety/depression (36.2%) were significant concerns. The EQ-5D index declined with increasing PASI scores (mild: 0.87, severe: 0.68, p < 0.01). Factors negatively associated with HRQOL included older age (Coef. =-0.003, p = 0.026), severe redness (Coef. =-0.199, p = 0.001), and pain symptoms (Coef. =-0.108, p = 0.031). Male sex was independently associated with higher HRQOL (Coef. = 0.084, p = 0.015). Fraizeron treatment was positively associated with higher HRQOL (Coef. = 0.164, p = 0.048). Conclusions: psoriasis substantially impacts HRQOL, particularly through pain and emotional burden. Older age, severe redness, and pain symptoms were associated with poorer HRQOL, whereas male sex and Fraizeron treatment were associated with higher HRQOL. Comprehensive management strategies addressing both physical symptoms and psychological well-being may help improve HRQOL.
Objective: this study aims to examine temperament, character, and personality traits (at both the intrapsychic and interpersonal levels) in women with a history of CSA, in order to identify patterns that could enhance therapeutic interventions. Method: a sample of 88 women with a history of CSA was compared to a group of 130 non-CSA women. All participants completed the Revised Temperament and Character Inventory (TCI-140) and the Structural Analysis of Social Behavior (SASB) Form-A [8 Clusters (Cl)]. Results: women with CSA exhibited significantly higher levels of Novelty-Seeking (NS) (p = .011) and lower levels of Self-Directedness (SD) (p = .001) compared to the non-CSA group. They also scored lower on SASB-Cl-1 (p = .001), SASB-Cl-2 (p = .001), and SASB-Cl-3 (p = .025), indicating lower autonomyassertivity, self-acceptance and self-appreciation. In contrast, they had higher scores on SASB-Cl-6 (p = .001), SASB-Cl-7 (p = .001), and SASB-Cl-8 (p = .001), reflecting self-criticism, self-rejection, and emotional disconnection. Significant correlations were observed between the TCI-140 dimensions and SASB-Cl. Conclusions: the study highlights distinct personality and behavioral profiles in women with CSA, which may contribute to self-injurious tendencies and interpersonal challenges. These findings underscore the necessity of personalized psychotherapeutic approaches that target these maladaptive intrapsychic and temperamental patterns to improve psychological outcomes in this vulnerable population.s.
Objective:Despite promising data from rodent models demonstrating a link between adropin deficiency and cognitive dysfunction, in-depth examinations of such an association in humans are lacking. Accordingly, the present study investigated the relationship between serum adropin levels and cognitive function in a sample of elderly individuals. Method:This cross-sectional study included 90 elderly (≥ 65 years of age) participants from geriatric outpatient clinics at Mansoura University (Mansoura City, Egypt), who were classified with normal cognition, mild neurocognitive disorder/mild cognitive impairment, or major neurocognitive disorder/dementia according to criteria from the Diagnostic and Statistical Manual of Psychiatric Disorders, Fifth Edition. Assessments included a comprehensive geriatric evaluation, cognitive testing, and measurement of serum adropin levels and metabolic parameters. Results:Multivariate regression (R2= 0.464) revealed that serum adropin (β = 3.09, p < 0.001), education ≥ 4 years (β = 1.47, p = 0.040), and total cholesterol level (β = -0.02, p = 0.004) were independently associated with Mini-Mental State Examination scores. Adropin levels ≤ 1.9 ng/mL yielded 90.2% sensitivity and 95.9% specificity for discriminating cognitive impairment (mild cognitive impairment and dementia), and ≤ 1.6 ng/mL specifically for dementia, with 83.3% sensitivity and 93.1% specificity. Conclusions:Lower serum adropin levels were significantly associated with cognitive impairment in elderly individuals, with strong diagnostic discriminative ability (area under the receiver operating characteristic curve, 0.993). However, larger-scale longitudinal studies are required to establish causality and validate these findings.
Objectives: Alterations in motor inhibition (MI) may be involved in the homotypic and heterotypic developmental pathways of substance use disorders (SUDs) and related conditions (e.g., binge drinking). However, no studies have clarified the neurobehavioral correlates of MI across the various conditions (e.g., ADHD and major depressive disorder in childhood/adolescence) constituting developmental trajectories of SUDs and related problems, especially within a self-regulation conceptual framework. Method: A multi-method meta-analysis (i.e., voxel-based, network, and multilevel) of MI tasks (i.e., Go/No-Go; Stop Signal) was conducted. Neuroimaging (fMRI) and event-related potential (ERP) data were analyzed. The study included children and adolescents with ADHD, adolescents with major depressive disorder, and subjects with SUDs and related conditions. Results: Sixty-eight studies (fMRI: 42; ERPs: 26) were included. The analysis showed a shared increased responsiveness of the rostral anterior cingulate cortex among conditions of interest during "No-Go" trials compared to healthy controls (HCs). Reduced N200/P300 waves, together with increased reaction times in response to MI task experimental conditions, were found among conditions of interest compared to HCs. Network meta-analysis results showed that distinct patterns of neural activity linked to different self-regulation domains differentiated these clinical conditions from one another. Conclusions: Common and distinct patterns of neuro-behavioral responses associated with self-regulation mechanisms, especially regarding MI, should be considered key latent dimensions involved in the homotypic and heterotypic developmental pathways of SUDs and related problems.
Objective:Genome-wide association studies have identified shared genetic risk loci between schizophrenia (SCZ) and multiple sclerosis (MS), suggesting overlapping biological mechanisms despite distinct clinical presentations. Here, we aimed to characterize the biological plausibility of KIF21B as a shared genetic risk gene for SCZ and MS, two disorders with overlapping genetic risk loci despite distinct clinical presentations. Method:We performed bioinformatics analyses of KIF21B using publicly available data from GTEx, STRING, and the GWAS Catalog, including tissue-specific expression profiling, protein interaction network analysis, transcriptome-wide co-expression analysis, and phenome-wide association analysis. Results:KIF21B expression was significantly enriched in both brain and immune tissues compared to other tissue types. Protein interaction network analysis demonstrated that KIF21B functions within microtubule-based transport machinery essential for axonal function. Co-expression analysis identified significant correlation with immune-related genes, including the established MS susceptibility gene ANKRD55, with pathway enrichment for T cell activation and lymphocyte diferentiation. Phenome-wide association analysis confirmed KIF21B pleiotropy across multiple autoimmune and psychiatric conditions. Conclusions:These findings support KIF21B as a biologically plausible shared risk gene whose dual neural and immune functions may contribute to susceptibility for both neuropsychiatric and autoimmune diseases of the central nervous system.
Objective: Cerebral palsy (CP) is a neurodevelopmental disorder primarily affecting motor functioning and often accompanied by cognitive impairments. Although intellectual profiles in children with CP are known to be heterogeneous, standard intelligence assessments often rely on a single global IQ score, which may obscure important intra-individual differences and limit clinical usefulness. This study aimed to explore intellectual functioning in children with unilateral and bilateral spastic cerebral palsy using a detailed multi-level analysis to examine how motor impairments may influence performance on WISC-IV indices and subtests. Method: A cross-sectional study was conducted on 48 children aged 6-15 years with spastic cerebral palsy (24 unilateral, 24 bilateral). Inclusion required at least one WISC-IV index score above 80. Intellectual functioning was assessed through Full Scale IQ, four cognitive indices (verbal comprehension, perceptual reasoning, working memory, processing speed), and individual subtests. Participants were classified by cerebral palsy type and gross motor function level. Descriptive and comparative statistics identified significant group differences. Results: Intellectual profiles showed marked heterogeneity. Over half of the children showed marked discrepancies among WISC-IV index scores, making the Full Scale IQ difficult to interpret as a representation of their overall cognitive functioning. Working Memory and Processing Speed were the most frequently impaired indices. Processing Speed deficits were consistent across CP types and motor levels, while Working Memory impairments were more pronounced in children with bilateral CP. Perceptual and verbal reasoning differences were more evident in bilateral cases. Greater motor impairment correlated with lower Perceptual Reasoning and Processing Speed scores, highlighting the influence of motor functioning on performance. Conclusions: Detailed, multi-level assessments of WISC-IV performance provides a clearer understanding of cognitive functioning in children with CP. Considering indices and subtests in relation to motor constraints helps distinguish true cognitive abilities from motor-related limitations, supporting accurate diagnosis and targeted interventions.
Objective: This study aims to explore the interplay between pathological narcissism, reflective functioning (RF), and peer exclusion (vs. inclusion) among adolescents. The study hypothesizes that peer exclusion (vs. inclusion) is associated with greater post-task difficulties in reflective functioning and higher rejection-related emotions, and tests whether these associations vary as a function of pathological narcissism. Method: A sample of 204 adolescents (aged 14-18) participated in an experimental task simulating social media interactions using the Social Media Ostracism Paradigm (SMOP). Participants were assigned to one of three experimental conditions: Over-Inclusion (OI), Neutral (N), and Over-Exclusion (OE). Pathological narcissism was assessed using the Pathological Narcissism Inventory (PNI), and reflective functioning and rejection-related emotions were evaluated post-task. Results: High-risk narcissistic adolescents exhibited significantly lower RF scores than their low-risk peers (F(1, 198) = 13.72, p < .001), particularly in the OE condition (F(2, 198) = 6.76, p < .001). Low-risk adolescents in the OI condition demonstrated better RF. Social exclusion significantly impacted rejection-related emotions (F(2, 198) = 13.890, p < .001), with OE participants reporting higher distress than N and OI groups. However, narcissism did not significantly moderate emotional responses. Conclusions: Pathological narcissism was associated with greater RF difficulties, which were most evident under exclusion. However, rejection distress appears to be a broadly shared response in adolescence and may function as a normative signal of threatened belongingness, relatively independent of narcissism levels. These results emphasize the importance of targeted interventions focusing on mentalization and peer dynamics, particularly for adolescents with high-risk narcissism traits.
Objective: Bullying is a serious problem among school-age children, contributing to both internalizing and externalizing difficulties. The existing literature does not place much emphasis on the factors explaining the link between victimization and psychological difficulties. This study looked into the roles of rumination and selfefficacy in this relationship. Method: Data was collected from 362 children (202 girls; Mage = 13.1, SD = 1.16) over two points in time, separated by 6 months. Results: Findings revealed a main effect of bullying status (being a victim of bullying vs. being non-involved) on rumination, self-efficacy, and internalizing/ externalizing symptoms. Additional analyses explored different existing profiles (noninvolved who stayed non-involved, new victims, escaped victims, and continuous victims) in terms of their psychological difficulties, ruminative responses, and selfefficacy. Mediation analyses show that victimization at Time 1 predicts internalizing difficulties at Time 2, but this effect is not mediated by rumination or self-efficacy. Conversely, victimization indirectly predicts externalizing symptoms at Time 2 via rumination. Moreover, internalizing symptoms at Time 1 predict victimization at Time 2 through both rumination and self-efficacy, while externalizing symptoms at Time 1 predict victimization at Time 2 via self-efficacy. Conclusions: The findings provide practical insights for those working with victims of bullying and also lay the foundation for future research.
Objective:This study assessed smartphone addiction, internet addiction, eHealth literacy, social support, loneliness, depression, and sleep quality among health sciences students, and examined their structural relationships using structural equation modeling (SEM). Method:A cross-sectional survey was conducted among 447 Medicine, Nursing, and Pharmacy students at a university in Hanoi. Data were collected using a self-administered paper questionnaire incorporating validated instruments: SAS-SV, IAT-6, eHEALS, DUFSSQ-8, UCLA-3, PHQ-9, and B-PSQI. Descriptive statistics, correlation analyses, and SEM were performed using Stata 17 and SmartPLS 3.0. Results:Participants reported moderate levels of smartphone addiction (35.7 ± 8.9) and internet addiction (13.1 ± 4.8). Internet addiction demonstrated direct effects on higher depression (β = 0.36, p < 0.001), poorer sleep quality (β = 0.27, p < 0.001), and lower social support (β = -0.25, p < 0.001). Smartphone addiction was positively associated with eHealth literacy (β = 0.21, p < 0.001) and loneliness (β = 0.16, p = 0.003). Social support showed strong inverse associations with depression, loneliness, and poor sleep, and mediated the effects of internet addiction on all three outcomes. eHealth literacy did not attenuate adverse effects. Conclusions:Among Vietnamese health science students, problematic smartphone and internet use is associated with greater loneliness, depressive symptoms, and sleep disturbances. Enhancing social support ‒ rather than relying solely on eHealth literacy ‒ appears critical to reducing these harms. Universities should implement strategies that foster digital well-being, limit problematic technology use, and strengthen peer connectedness and supportive campus environments.
Objective:To assess the prevalence of poor sleep quality and identify associated factors among patients with systemic lupus erythematosus (SLE). Method:A cross-sectional study was conducted at Bach Mai Hospital, Vietnam, from January 2024 to December 2024. Adult SLE patients meeting the ACR/EULAR 2019 classification criteria were consecutively enrolled. Data were collected on sociodemographic, clinical, behavioral, and psychological characteristics. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), with a global score >5 indicating poor sleep. Depression and anxiety were measured using the Beck Depression Inventory-II (BDI-II) and Hamilton Anxiety Rating Scale (HAM-A), respectively. Multivariate logistic and Tobit regression analyses were performed to identify factors associated with poor sleep quality and PSQI score. Results:A total of 453 SLE patients participated, of whom 66.7% exhibited poor sleep quality. In multivariate regression, poor sleep quality was independently associated with older age (OR: 1.05, 95% CI: 1.02-1.07), higher disease activity (SLEDAI; OR: 1.04, 95% CI: 1.01-1.06), greater organ damage (SLICC/ACR index; OR: 1.17, 95% CI: 1.02-1.34), and higher anxiety severity (mild: OR 2.51, moderate: OR 3.53). Alcohol use (OR: 0.24, 95% CI: 0.07-0.90) and opioid use (OR: 0.08, 95% CI: 0.01-0.99) were associated with lower odds of poor sleep quality. For PSQI score, worse sleep quality was significantly associated with older age (Coef.: 0.09, 95% CI: 0.06-0.11), more frequent lupus flares (2 episodes: Coef. 1.14; ≥3 episodes: Coef. 1.76), and higher anxiety severity (mild: 1.82; moderate: 2.34; severe: 3.99). Conclusions:Multidisciplinary approaches targeting psychological well-being, disease control, and healthy lifestyle behaviors are essential to improve sleep and quality of life in this population.
Objective: Neuromuscular disorders (NMD) are rare, chronic diseases affecting muscle and nerve function, leading to motor, cognitive, and socio-emotional challenges. While physical and cognitive aspects have been widely studied, socioemotional functioning remains underexplored. This study assessed the feasibility of using invented oral stories to examine internal state language in children with NMD compared to typically developing peers. Method: Forty 5-12 years old children (20 with NMD, 20 typically developing) spontaneously narrated fictional stories, analyzed for structure, cohesion, and psychological lexicon that refers to words expressing internal mental and emotional states. Results: Results showed no significant differences in narrative structure or cohesion, supporting the feasibility of oral storytelling. However, children with NMD used more physiological and socio-relational terms, emphasizing their attention to bodily experiences and social interactions as coping strategies. Conclusions: These findings highlight oral narratives as a valuable tool to access socio-emotional development in children with NMD through narrative-based interventions.
Objective:Cognitive impairment is a growing public health concern among aging populations, yet evidence from Vietnam remains limited. This study aimed to assess the prevalence of cognitive impairment among older adults in Hanoi and identify demographic, socioeconomic, lifestyle, and health-related determinants. Method:A cross-sectional study was conducted among 763 adults aged ≥60 years from one urban ward and one rural commune in Hanoi (June-December 2023). Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), with impairment classified into mild, moderate, and severe levels. Mental health, anxiety, and sleep quality were measured using the PHQ-9, GAD-7, and PSQI. Multivariate logistic regression with stepwise forward selection identified independent predictors of cognitive impairment. Results:Cognitive impairment was highly prevalent, affecting 70.4% of participants (46.1% mild, 19.3% moderate, 5.0% severe). Mean MoCA score was 21.3 (SD=6.3). Age was the strongest predictor (OR=1.11 per year, 95% CI: 1.08-1.15). Female gender (OR=1.63, 95% CI: 1.09-2.44), lower education (OR=0.58 for >high school vs <high school, 95% CI: 0.34-1.00), rural residence (OR=0.58, 95% CI: 0.34-0.99), and lack of pension income (OR=0.54, 95% CI: 0.32-0.93) were significant socioeconomic risk factors. Physical inactivity showed the largest effect size (OR=3.18, 95% CI: 1.34-7.55). Poor sleep quality (OR=1.62, 95% CI: 1.11-2.36) and mental health disorders (OR=1.91, 95% CI: 1.05-3.49) were also independently associated. No significant association was found with COVID-19 status. Conclusions:Cognitive impairment is widespread among older adults in Hanoi and is shaped by demographic, socioeconomic, and modifiable health factors. Interventions to promote physical activity, mental health, and economic security, alongside improved access to screening and elder care in rural areas, are essential for supporting healthy cognitive aging in Vietnam.
Objective:To determine the prevalence of poor sleep quality and identify associated factors among patients newly diagnosed with T2DM. Method:A cross-sectional study was conducted at the National Hospital of Endocrinology, Vietnam, from August 2024 to July 2025. A total of 106 patients with newly diagnosed T2DM were recruited. Data on sociodemographics, lifestyle, clinical and biochemical measures, social support (MSPSS), and quality of life (WHOQOL-BREF) were collected. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression was applied to identify predictors of sleep disorder (PSQI ≥5), and Tobit regression was used to examine determinants of the total PSQI score. Results:The mean PSQI global score was 6.86 ± 4.63, and 67.9% of participants experienced at least mild sleep disturbance. Logistic regression showed that elevated HbA1c (OR = 7.66, 95% CI: 2.81-20.86, p < 0.001) and female sex (OR = 0.13, 95% CI: 0.02-0.82, p = 0.029) were significant predictors of poor sleep. Tobit regression further identified HbA1c (Coef. = 1.45, p < 0.001), female sex (Coef. = -3.40, p < 0.001), economic stress (Coef. = -3.42, p < 0.001), WHOQOL physical (Coef. = -0.07, p = 0.027), and WHOQOL environment (Coef. = 0.11, p = 0.012) as significant determinants of PSQI score. Lifestyle factors and family support showed weaker or non-significant associations. Conclusions:These findings suggest that sleep should be routinely assessed at diagnosis, with integrated management strategies addressing biomedical, psychosocial, and environmental determinants to improve outcomes.
Objective:This narrative review examines clinical, genetic, and epidemiological evidence on schizophrenia (SCZ) to identify predictors of self-harm and violence, summarize genetic contributors to SCZ including pleiotropy and links between polygenic burden and negative/disorganized symptoms, and evaluate implications for early identification and predictive tools. Method:We synthesized findings from large-scale genome-wide association studies, rare variant and polygenic risk research, gene-environment interplay, epidemiological studies on suicide and violence, and clinical trials of early-intervention programs for SCZ. Results:SCZ involves a complex genetic architecture that includes hundreds of common risk variants and rarer coding and structural mutations. These genetic factors interact with environmental exposures, particularly childhood adversity and substance use, to shape vulnerability trajectories. Suicidality is a leading cause of excess mortality in SCZ, especially in early disease phases. Violence risk is modest overall but elevated in individuals with untreated psychosis or comorbid substance misuse. Emerging findings suggest that polygenic burden is linked to negative and disorganized symptoms, which in turn associate with worse clinical outcomes. Early, sustained, multicomponent intervention improves symptoms, functioning, and treatment adherence and may reduce self-harm and indirectly mitigate violence by addressing modifiable risk factors. Emerging machine learning models, though not yet widely validated, show promise in identifying individuals at higher risk of suicide or aggression by integrating clinical, demographic, and biological features. Conclusions:Integrating genetic, clinical, and environmental data can enhance risk stratification and support precision prevention in SCZ. Polygenic risk scores are not yet clinically predictive alone but may add value when combined with symptom profiles and early-life adversity for early identification and detecting susceptibility to negative/disorganized symptoms. Near-term priorities include externally validating prediction tools, standardizing screening for trauma exposure and substance use within early-psychosis services to guide monitoring intensity and relapse-prevention planning, and scaling coordinated specialty care.
