Supported Accommodations (SA) are central to Italy’s community-based mental health care for individuals with schizophrenia spectrum disorders (SSD), offering structured, recovery-oriented environments. While symptom severity remains important, care environment and satisfaction strongly influence well-being. Mood fluctuations, a key aspect of daily functioning, have been underexplored in SA. Using the Experience Sampling Method (ESM), this study aims to examine the associations between perceived ward atmosphere, care satisfaction, and momentary mood in SA residents with SSD. As part of the DiAPAson project, 68 residents with SSD were assessed also using ESM. Additional measures included psychopathology (BPRS, BNSS), functioning (SLOF, WHODAS 2.0), perceived ward atmosphere (WAS-P) and service satisfaction (VSSS-32). Descriptive analyses were conducted, and a structural equation model examined mood in relation to clinical, demographic, and environmental factors. Residents with SSD (29.4
Sleep disturbances are established risk factors for suicidal thoughts and behaviors, but it remains unclear whether distinct sleep profiles differentially associate with specific suicide‑related symptoms after adjustment for psychiatric symptom dimensions. In this cross-sectional, person-centered analysis of 15,396 adult outpatients with sleep complaints from a psychiatric specialist hospital in China, sleep profiles were identified via latent profile analysis (LPA) using seven Pittsburgh Sleep Quality Index (PSQI) dimensions. Suicide-related symptoms were assessed with three Symptom Checklist-90 (SCL-90) items: active suicidal ideation, death-related thoughts, and guilt. Logistic regression adjusted for age, sex, and other SCL-90 dimensions examined associations between sleep profiles and each outcome, with false discovery rate (FDR) correction. After adjustment for age, sex, and other psychiatric symptom dimensions, three profiles (Mild Disturbance, Severe Insomnia, and Moderate Non‑Medicated) showed elevated odds of active suicidal ideation (aORs 1.22–1.25). In exploratory adjusted analyses, death-related thoughts showed suggested associations with the Medication Use but Functional and Moderate Non-Medicated profiles, but these did not remain statistically significant after FDR correction and the overall sleep profile effect was marginal. Guilt showed no significant associations after adjustment. Notably, the Moderate Non‑Medicated profile had the highest symptom rates despite milder sleep impairment. These findings indicate that suicide‑related symptoms are not driven solely by sleep severity but follow profile‑specific patterns, supporting refined clinical risk stratification. Not applicable.
This study aimed to compare ventromedial prefrontal cortex (vmPFC) neurometabolites in adolescents with bipolar II disorder (BD-II) with and without clinically significant obsessive-compulsive symptoms (OCS) and examine their clinical associations. A total of 28 adolescents with BD-II depression and clinically significant OCS (BD-II-OCS), 30 adolescents with BD-II depression without OCS (BD-II-non-OCS), and 26 healthy controls (HCs) were recruited. N-acetylaspartate-to-creatine (NAA/Cr), choline-containing compounds-to-creatine (Cho/Cr), myo-inositol-to-creatine (mI/Cr), and glutamate plus glutamine-to-creatine (Glx/Cr) ratios in the vmPFC were measured using single-voxel proton magnetic resonance spectroscopy (¹H-MRS). Compared with the HC group, the NAA/Cr ratio was significantly lower in both BD-II groups, with the lowest value in the BD-II-OCS group; the Glx/Cr ratio was also significantly lower in the BD-II-OCS group than in the other two groups. These group differences remained significant after adjustment for illness duration and other covariates. The BD-II-OCS group had a longer illness duration than the BD-II-non-OCS group, and Glx/Cr was negatively correlated with HDRS-24 scores only within the BD-II-non-OCS group. In exploratory in-sample ROC analysis, NAA/Cr yielded an AUC of 0.870 for discriminating BD-II-OCS from HC and an AUC of 0.733 for discriminating between the two patient groups. Adolescents with BD-II depressive episodes accompanied by clinically significant OCS exhibited lower vmPFC NAA/Cr and Glx/Cr ratios, suggesting possible alterations in neuronal integrity and glutamatergic metabolism. NAA/Cr showed preliminary in-sample discrimination, but independent validation across the full OCS severity range is required.
Exercise is proposed as an adjunct for emotional and behavioral difficulties in youth with attention-deficit/hyperactivity disorder (ADHD), but overlapping reviews may overstate the evidence. Seven databases were searched through 1 June 2026 and updated on 20 August 2026. Eligible reviews addressed exercise and emotional-behavioral outcomes in participants aged under 18 years with ADHD. Screening and extraction were independently duplicated, with third-reviewer adjudication. Methodological confidence was assessed using AMSTAR 2; planned ROBIS assessment was not undertaken. Overlap was quantified using corrected covered area (CCA). Only verifiable, outcome-specific source certainty ratings were retained. A post hoc hierarchy selected one review for highly overlapping constructs and was examined in sensitivity analyses. Estimates were not re-pooled. Fourteen reviews covered 132 unique primary studies, including 109 in the ADHD-specific core evidence base; the update added no eligible review. AMSTAR 2 confidence was moderate in one review, low in five, and critically low in eight. CCA was 7.46
Transition-age youth (TAY) face heightened risk for the onset of psychiatric disorders and significant discontinuities when moving from child/adolescent to adult mental health services. Early intervention models, including clinical staging and transdiagnostic approaches, have been proposed to bridge this “transition gap” and improve continuity of care. Following PRISMA 2020 guidelines, we conducted a systematic review registered in PROSPERO (CRD42024595896). Searches across five databases (PubMed, PsycINFO, Scopus, ProQuest, Cochrane) identified publications between 2013 and 2025 describing service models or early interventions for TAY. Eligible studies included quantitative, qualitative, and mixed methods designs. Methodological quality was appraised using design-specific tools (AMSTAR, NOS, Jadad, SANRA), with item-level scoring reported in Appendix 2. Twenty-six studies met inclusion criteria, spanning Europe, North America, and Australia. Observational and longitudinal designs predominated, with interventions embedded in youth-specific service models such as headspace (Australia), ReARMS (Italy), FREED (UK), and NAVIGATE (USA). Across contexts, key themes emerged: youth-friendly design and accessibility, autonomy and functional recovery, multidisciplinary integration, preventive focus, societal engagement, continuity of care, systemic challenges, and economic evaluation. Methodological quality was moderate to good. Integrated hubs and structured transition protocols consistently reduced disengagement, while preventive strategies targeting subthreshold symptoms demonstrated feasibility and early efficacy. However, variability in fidelity, systemic gaps (such as lack of national protocols, insufficient resources), and uneven accessibility remain barriers to scale-up. Early intervention models for TAY show promise in improving continuity of care, reducing dropout, and supporting functional recovery. Youth-friendly, integrated, and preventive approaches are central to effective service design, yet systemic and policy-level reforms are required to ensure sustainability and equitable access. Future research should prioritize comparative evaluations, long-term outcomes, and strategies for embedding early intervention into routine practice across diverse health systems.
