The triglyceride-glucose (TyG) index serves as an innovative proxy for insulin resistance (IR) and has been correlated with cognitive performance. IR is prevalent in schizophrenia (SZ) patients and could potentially influence cognitive function. Nevertheless, the association between the TyG index and cognitive impairment in first-episode drug-naive (FEDN) SZ patients remains unexplored. The cross-sectional study recruited a large sample of 498 FEDN SZ patients, as well as 201 healthy controls matched for sex and age, whose age range is 16–48 years.Sociodemographic characteristics and clinical data were collected. Psychotic symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS), while cognitive function was assessed with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The TyG index was calculated based on fasting triglyceride and glucose levels. The relationship between the TyG index and cognitive function was assessed using methods such as generalized linear models (GLM) and smooth fit curves. After controlling for potential confounders, the TyG index exhibited significant negative associations with immediate memory (β = -7.77), attention (β = -9.09), delayed memory (β = -11.39), and RBANS total score (β = -7.20) (all p < 0.001). Quartile analysis revealed that elevated TyG index values corresponded to decreased cognitive function scores (all p < 0.001). Stratified analyses indicated that these associations were consistent across sex, age, education, smoking, drinking status, and BMI (all p > 0.05). In FEDN SZ patients, the TyG index negatively correlates with cognitive impairment, specifically affecting immediate memory, attention, delayed memory, and overall cognitive function as measured by the RBANS. This suggests that the TyG index may serve as a potential indicator associated with cognitive impairment in this population. Routine assessment of the TyG index may help identify cognitive impairment in FEDN SZ patients, though longitudinal studies are needed to establish its clinical utility. These findings warrant further investigation to determine whether the TyG index could inform early identification strategies for cognitive decline in this population. retrospectively registered. not applicable.
Major depressive disorder (MDD) is a debilitating condition characterized by disturbances in circadian rhythms, gut microbial composition, and epigenetic patterns, yet the integrative relationships among these systems remain poorly understood. We conducted a cross-sectional study involving 49 first-episode, drug-naïve MDD patients and 35 healthy controls (HCs). Circadian rhythms were evaluated using the Munich Chronotype Questionnaire, with two key metrics—corrected mid-sleep time on free days and social jetlag—selected for analysis. Fecal samples were subjected to shotgun metagenomic sequencing, and peripheral blood DNA methylation was characterized via reduced-representation bisulfite sequencing (RRBS). Multi-omics integration was performed using weighted gene co-expression network analysis (WGCNA) and correlation analyses. While gut microbial alpha diversity was comparable, beta diversity uncovered significantly distinct gut microbial communities between MDD patients and HCs. WGCNA detected microbial modules significantly correlated with circadian parameters. RRBS analysis identified 9,749 differentially methylated genes (DMGs) in MDD, which were annotated as enriched in neural-related pathways based on gene ontology and KEGG analyses. These enrichments provide hypothesis‑generating evidence for potential systemic associations, but do not establish that peripheral blood methylation directly reflects brain methylation status. Crucially, integrative analysis identified 9 key microbial operational taxonomic units that were simultaneously linked to circadian rhythm measures and the methylation rates of 898 neurodevelopment- and synaptic function-related DMGs. Our findings identify a preliminary cross-sectional associative network among circadian rhythm disturbance, specific gut microbial variation and peripheral DNA methylation signatures in MDD, providing a hypothesis for subsequent mechanistic exploration rather than confirming causal pathogenic mechanisms. These findings suggests a potential integrative framework for understanding MDD pathophysiology and providing a preliminary exploratory multi-omic network hypothesis for understanding MDD pathological correlates and guiding further mechanistic verification.
Insight impairment is a core clinical feature of schizophrenia that predicts poor treatment adherence and unfavorable prognosis. Genetic factors have been increasingly recognized as a likely basis for inter-individual variability in insight; however, direct evidence for a complete mechanistic chain—from specific genetic variants through insight impairment to clinical outcomes—remains to be established. We enrolled 233 antipsychotic-free patients with first-episode schizophrenia. Five SNPs previously implicated in insight (SOX2-OT rs1479165 and DISC1 rs821616, rs821597, rs821633, rs6675281) were genotyped. Insight was assessed using the Birchwood Insight Scale (BIS) and treatment response was measured as PANSS reduction rate at 8 weeks. Mediation analysis, brain expression quantitative trait locus (eQTL) (GTEx v8), and STRING protein–protein interaction network were integrated to explore the pathway from genotype to clinical outcome. The SOX2-OT rs1479165 C allele was significantly associated with better insight (β = 2.03, p < 0.001). Baseline BIS score significantly predicted PANSS reduction rate (β = 3.175, p < 0.001). Mediation analysis demonstrated that the effect of SOX2-OT on treatment response was predominantly mediated by baseline insight (ACME = 6.11, 95
Reduction of gaming time is a common means to prevent internet gaming disorder (IGD) among adolescents at risk of IGD. According to the Social Cognitive Theory, environmental factors (e.g., perceived parental IGD and parental invitations to co-play) and cognitive factors (e.g., positive outcome expectancy of internet gaming) are potential determinants of the behavioral intention to reduce gaming time. With informed consent, a cross-sectional survey was conducted in two Chinese cities from October 2019 to January 2020 among students who self-perceived as having IGD. The sample size was 1,039. The prevalence of probable IGD in the sampled at-risk adolescents was 24.4
The 10-item Perceived Stress Scale (PSS-10) is widely used internationally, but its measurement properties have not been evaluated in Danish adolescents. The aim of this study was to assess the structural, construct, and criterion validity, internal consistency, test-retest reliability, and measurement precision of the Danish PSS-10, and to explore its ability to discriminate between adolescents with and without clinically assessed psychiatric diagnoses. A random sample of 5,699 adolescents aged 15–20 years was invited to participate. Of these, 667 completed the PSS-10 questionnaire in the first round (test sample), and 182 completed it a second time after approximately one week (retest sample). Structural validity was assessed using confirmatory factor analysis (CFA) using one- and two-factor models. Internal consistency was evaluated using Cronbach’s alpha. Test-retest reliability (n = 182) was evaluated using intraclass correlation coefficients (ICC) and the standard error of measurement (SEM). Construct and criterion validity was assessed in a subsample (n = 38) who completed a Schedules for Clinical Assessment in Neuropsychiatry (SCAN) interview. Receiver operating characteristic (ROC) analysis was used to examine the discriminative ability of the PSS-10 in relation to clinically assessed psychiatric diagnoses and to explore a potential threshold score. The two-factor model showed the best statistical fit, although the overall pattern of findings supported use of the total PSS-10 score. Internal consistency was excellent, as indicated by a Cronbach’s alpha = 0.90. Test-retest reliability was high with a ICC(2,1) = 0.89 and SEM = 2.65 resulting in a minimal detectable change of 7.34, which corresponds to an 18
Leveraging Turkey’s unique socio-cultural context, this cross-sectional study aimed to investigate the specific relationships between religious motivation, dysfunctional cognitive beliefs, and symptom dimensions in individuals with Obsessive-Compulsive Disorder (OCD) compared to healthy controls. The sample comprised 169 participants: a clinical group with primary OCD without current psychiatric comorbidities (n = 93) diagnosed via SCID-5-CV, and a healthy control (HC) group (n = 76). Participants completed the Motivational Religiosity Scale (MRS), Obsessive Beliefs Questionnaire (OBQ-44), and Padua Inventory (PI-WSUR). Group comparisons were evaluated using unadjusted t-tests and Analysis of Covariance (ANCOVA) adjusting for sociodemographic confounders (education, income, employment, marital status, alcohol use). Correlation analyses were adjusted for multiple comparisons using the Holm-Bonferroni procedure. Unadjusted comparisons showed significantly higher MRS total scores in the OCD group compared to controls (M = 110.85 ± 28.56 vs. 92.75 ± 31.56; t=-3.91, p<.001, Cohen’s d = 0.60). This group difference remained statistically significant in ANCOVA models controlling for sociodemographic covariates (F(1,161) = 9.84, p=.002, partial η2=0.058). In bivariate correlation analyses, religiosity (MRS) correlated positively with overall obsessive beliefs and multiple symptom subscales in healthy controls. Within the clinical OCD group, religiosity demonstrated a robust positive correlation strictly with the OBQ Importance/Control of Thoughts subscale (ρ = 0.381, praw=0.0002, padj=0.002), which was maintained in multivariable linear regression adjusting for sociodemographic confounders (β = 0.341, p=.001). Religiosity was not associated with overall OCD symptom severity (PI-WSUR Total) or broad symptom dimensions in the clinical sample. Religious motivation is elevated in primary OCD and displays a domain-specific, selective association with cognitive beliefs regarding the importance and control of thoughts, independent of sociodemographic confounders. Findings suggest that religious motivation interacts with OCD primarily at the cognitive appraisal level rather than acting as a global driver of overall symptom severity.
The anxious distress specifier (ADS) identifies a subtype of major depressive disorder (MDD) characterized by heightened anxiety and poorer outcomes. However, the neurobiological mechanisms underlying ADS remain poorly understood. This study investigated alterations in amygdala subregional resting-state functional connectivity (rsFC) in ADS and explored their associations with clinical symptoms. A total of 119 unmedicated patients with MDD and 65 healthy controls (HC) were included in the analysis. Based on DSM-5 criteria, patients were categorized into ADS (n = 68) and non-ADS (n = 51) subgroups. Group differences in rsFC of six amygdala subregions were examined. Multivariate correlation analyses were conducted to assess associations between rsFC strength and clinical symptoms. Moderation analyses were tested to determine whether anxious distress moderated the relationship between rsFC and clinical symptoms. Compared with non-ADS patients and HC, ADS patients exhibited significantly reduced rsFC between the left superficial amygdala (SFA) and the right middle occipital gyrus (MOG). In the ADS group, the left SFA–right MOG rsFC strength was positively correlated with early morning awakening, whereas in the non-ADS group, it was negatively correlated with difficulty falling asleep. Moderation analysis revealed a significant rsFC × group interaction, indicating that anxious distress significantly moderated the relationship between SFA–MOG connectivity and sleep disturbance. Our findings suggest that disrupted SFA–MOG connectivity might represent a neurobiological feature specific to the ADS subtype of MDD and may underlie sleep-related pathophysiology. These results highlight the importance of amygdala subregional analyses in elucidating neurobiological heterogeneity in MDD and warrant further validation in larger and independent cohorts.
Despite the high rates of both violence victimization and perpetration in people experiencing mental illness, standardized screening tools in research and for routine psychiatric assessment are lacking, underscoring the need for feasible, standardized assessment approaches. A sample of adult psychiatric in- and out-patients at six German hospitals was surveyed, using the Interpersonal Violence Questionnaire (IVIQ), a 26-item self-report checklist assessing experiences of physical violence, sexual violence, and threats, both as victimization and perpetration, across the past 12 months and lifetime. Exploratory analyses included prevalence estimates, scoring characteristics, floor effects, inter-item associations, temporal stability, and associations with social desirability. In 479 patients, lifetime sexual victimization and 12-month violence threat, as well as being pushed, were most frequent. IVIQ sum scores showed strong floor effects. Reports of victimization and perpetration frequently co-occurred; descriptive inter-item correlations were low to moderate. Temporal consistency varied across items, with lower stability for low-prevalence behaviors. Higher social desirability predicted lower 12-month perpetration reporting. The IVIQ may provide a feasible, structured self-report approach for routine assessment of interpersonal violence involvement in psychiatric populations. Different scoring approaches may support descriptive assessment of cumulative burden and distinct forms of interpersonal violence involvement. Future versions should broaden the assessment of psychological violence. Associations between social desirability and reporting underline the importance of sensitive implementation, trauma-informed assessment practices, and cautious interpretation of self-reported violence experiences. This study is registered in the German Clinical Trial Register (DRKS) and the WHO International Clinical Trials Registry Platform (ICTRP) under registration number DRKS00032041 (Date of registration: 20th of July 2023).
Cognitive disengagement syndrome (CDS) is an emerging cognitive-attentional construct characterized by excessive daydreaming, mental slowness, drowsiness, and reduced engagement with external demands. Although CDS symptoms are substantially associated with attention-deficit/hyperactivity disorder (ADHD) symptoms, accumulating psychometric and external-validity evidence supports their conceptualization as related yet distinguishable symptom dimensions. However, large-scale evidence regarding the distribution and demographic correlates of elevated CDS symptoms, as well as their differentiation from ADHD symptoms, remains limited, particularly in non-Western contexts. In this large-scale cross-sectional study, 8,075 Iranian participants aged 15–55 years, recruited through convenience and snowball sampling, completed the Persian Adult Concentration Inventory as a self-report measure of CDS symptoms. A subsample of 2,012 participants also completed the Adult ADHD Self-Report Scale. The study examined the distribution and demographic correlates of elevated CDS symptoms and the extent to which CDS and ADHD symptom dimensions showed overlap and differentiation. Sample-based percentile thresholds were used to identify elevated symptom levels. Analyses included descriptive statistics, logistic regression, correlation and overlap analyses, discriminant function analysis, and leave-one-out cross-validation. Using the sample-based 95th-percentile threshold, 5.8
Major depressive disorder (MDD) in youth is associated with higher suicide risk. Although white matter and functional connectivity abnormalities have been reported in MDD patients with suicidal ideation (SI), how brain structure and function interact abnormally remains unclear. We conducted a cross-sectional study of participants aged 15–30, including 97 drug-naive MDD patients with SI, 44 without SI (nSI), and healthy controls (HC). We analyzed global and local structural-functional connectivity (SC-FC) coupling across groups and assessed its correlation with clinical features. The study revealed significant differences in SC-FC coupling among the three groups (SI, nSI, and HC). At the local level, differences were identified in the left superior temporal gyrus (STG.L) and left Heschl’s gyrus (HES.L). Specifically, the SI group exhibited the weakest negative SC-FC coupling in the HES.L compared to both the nSI group and HC group (PFDR < 0.001). Additionally, a decrease in negative SC-FC coupling in the STG.L was observed in the SI group when compared to the HC group (PFDR = 0.003). The HES.L SC-FC coupling alterations were negatively correlated with clinical symptoms of rumination and suicidal risk in the SI group. The findings suggest that MDD patients with SI exhibit disrupted SC-FC coupling, particularly in the HES.L and STG.L regions. These alterations were associated with higher levels of rumination and suicidal risk, underscoring the potential of SC-FC coupling as a candidate neurobiological correlate of suicidal ideation in MDD.
Youth major depressive disorder (MDD) is a debilitating condition associated with high rates of suicidal behavior. Although abnormal neuroimaging alterations have been reported in MDD patients with suicidal ideation (SI), little is known about the mechanisms of brain dynamics at high temporal resolution. This cross-sectional study included 177 participants aged 15–30 years: 95 with drug-naïve MDD (53 with SI, 42 without SI) and 82 healthy controls. All participants underwent a standardized 5-minute resting-state electroencephalography (EEG) acquisition. Comprehensive clinical assessments were administered, including the collection of psychosocial data and evaluation of suicide risk using the Beck Scale for Suicide Ideation (BSI-C). Group differences in microstate parameters were analyzed, and correlations between these parameters and clinical variables were examined. Resting-state EEG microstate analysis indicated that the SI group, relative to the NSI group, exhibited higher occurrence, coverage, and duration of microstate A, along with decreased indices for microstate B and reduced occurrence (but not coverage or duration) of microstate D. Alterations in transition probabilities were most prominent in microstates A and B, highlighting specific network-level differences associated with SI. In the SI group, BSI-C scores were positively correlated with the transition probability from C to B. Our findings suggest that young individuals with MDD and SI show specific changes in microstates, especially A and B. These findings reveal altered EEG microstate dynamics associated with SI in young MDD patients and may inform future research on neurophysiological correlates of suicidal ideation.
Abstract Background Substance use and co-occurring mental health conditions are common among adolescents and young adults and represent an important clinical and public health concern in North America. Trauma exposure, psychiatric symptoms, and social adversity frequently co-occur with substance-related problems in this population. This systematic review aimed to synthesize evidence on prevalence patterns, associated clinical and psychosocial factors, and care-related implications described in the literature on adolescents and young adults with substance use and co-occurring mental health conditions. Methods This systematic review followed PRISMA guidelines and was preregistered in PROSPERO (CRD42024581685). A systematic search was conducted in MEDLINE (Ovid), Embase, PsycINFO, and Google Scholar. Eligible studies examined adolescents and young adults (≤ 25 years) in North America. A combination of subject headings, keywords, and synonyms for the concepts “adolescents,” “young adults,” “substance use disorders,” and “co-occurring mental health conditions” was used. Of 1,882 records identified, 29 studies met the inclusion criteria. Given the heterogeneity of the literature, findings were synthesized narratively. Results The included studies showed heterogeneity in population, setting, denominator, and ascertainment method. Across the literature, depressive, anxiety-related, trauma-related, and externalizing mental health presentations were frequently reported alongside substance-related problems in adolescents and young adults. Trauma exposure, adverse childhood experiences, and broader social adversity were also commonly reported in association with substance-related problems across studies. Care-related implications were more limited and were largely derived as future directions mentioned across studies rather than direct evaluations of youth-specific service models. Conclusion Co-occurring mental health and substance-related problems were frequently reported among adolescents and young adults in high-risk and service-engaged populations in North America. Trauma and social adversity were prominent across the reviewed literature, while direct evidence for evaluated, integrated, youth-specific care models remains limited. These findings support the relevance of developmentally appropriate, integrated, and trauma-informed approaches to care and highlight the need for further research directly evaluating improved service delivery models for this population. Clinical trial number Not applicable.
Systemic inflammatory and nutritional indices derived from hematological parameters have emerged as accessible markers of immune imbalance. Although these indices have been investigated across various medical disciplines, their roles in psychiatric patients with positive urinary drug metabolites have not yet been reported. This study aimed to compare hematological inflammation and nutritional indices between psychiatric patients with positive urinary drug metabolites and healthy controls, to evaluate the Systemic Inflammation Response Index (SIRI), Systemic Immune-Inflammation Index (SII), and Prognostic Nutritional Index (PNI), explore their variations across substance types and usage patterns, and determine their association with immune–nutritional dysregulation. This retrospective study included 760 psychiatric inpatients with positive urinary drug metabolites, 171 psychiatric patients without positive metabolites, and 151 healthy controls treated at X City Hospital between 2022 and 2024. SIRI, SII, and PNI were calculated from hematological and/or biochemical parameters. Patients with infectious, autoimmune, or malignant diseases or incomplete data were excluded. Group comparisons, age- and sex-adjusted regression analyses, multiple-comparison corrections, and ROC analyses were performed. Patients had higher SIRI [1.24 (0.79–1.97) vs. 0.98 (0.74–1.27)] and lower PNI (56.0 ± 6.12 vs. 58.8 ± 3.87) than controls (both p < 0.001), whereas SII did not differ significantly between the groups (p = 0.108). SIRI was positively associated with disease presence (OR = 1.847, 95
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social communication and interaction, along with restricted, repetitive patterns of behavior. It is often accompanied by gastrointestinal dysfunction and gut microbiota dysbiosis. Fecal Microbiota Transplantation (FMT) and the Ketogenic Diet (KD) are interventions targeting the gut microbiota for ASD. 30 participants were diagnosed with ASD according to DSM-5 and ADOS-2. ASD core symptoms were evaluated with CARS and ABC. Gut microbiota composition was analyzed by shotgun metagenomic sequencing. Both groups demonstrated significant improvements in core symptoms. In the FMT group, the mean CARS score significantly decreased from 34.87 to 33.53 (p < 0.01); in the KD group, it declined from 35.13 to 33 (p < 0.01). The mean ABC score reduced from 79.93 to 69.33 (p = 0.064) in the FMT group and from 63.07 to 42.73 (p < 0.01) in the KD group. Following the intervention, no statistically significant changes were observed in α-diversity or β-diversity within either group. LEfSe analysis revealed distinct post-intervention microbial signatures: FMT significantly enriched butyrate-producing taxa (Wujia chipingensis, Eubacterium sp. MSJ-33, and Butyrivibrio crossotus), while KD elevated Blautia massiliensis and decreased propionate metabolism -associated taxa (Veillonella sp. S12025-13 and Veillonella nakazawae). KEGG enrichment analysis revealed that KD enriched propionate metabolism (Fold enrichment = 3.747, q = 0.010) and aromatic compound degradation (Fold enrichment = 3.591, q = 0.010). Both interventions significantly improved clinical symptoms among children with ASD, potentially through distinct patterns of gut microbiota modulation. NCT06348433 (03/21/2024).
Delirium is a common neuropsychiatric complication in hospitalized patients with coronavirus disease 2019 (COVID-19) and has been linked to short-term mortality. However, its long-term prognostic significance and whether it independently contributes to death remain unclear. This multicenter cohort study aimed to identify the risk factors for delirium and evaluate their prognostic significance. This retrospective cohort study included 1,030 patients with COVID-19 at two tertiary hospitals in Seoul and Gyeonggi-do, South Korea (January 2021 to December 2022), excluding those with prior dementia. Delirium was assessed using the Confusion Assessment Method and diagnosed according to DSM-5 criteria. Logistic regression was used to identify the risk factors for delirium. Kaplan-Meier analysis and Cox regression were used to evaluate survival. Among 1,030 patients (mean age 62.9 years, 44.4
Dynamic functional network connectivity (dFNC) has become a powerful method for assessing time-varying brain dynamics in psychiatric disorders. However, it is unclear whether disruptions in network dynamics reflect disorder-specific dysfunction or shared transdiagnostic mechanisms. This work examined network state transitions and connectivity patterns in schizophrenia (SZ) and attention-deficit/hyperactivity disorder (ADHD) using resting-state functional magnetic resonance imaging (rs-fMRI) data. A sliding-window approach with k-means clustering identified four distinct, recurring dFNC states. Group differences in state-specific connectivity patterns, mean dwell time (MDT), fraction of time (FOT), and state transitions were evaluated along with correlations between dFNC temporal metrics and clinical symptoms. Schizophrenia demonstrated increased MDT and FOT in states characterized by reduced network integration and greater segregation, compared to both ADHD and healthy control (HC). ADHD spent more time in states reflecting moderate connectivity patterns, suggesting altered but more flexible network dynamics relative to schizophrenia. Schizophrenia also showed increased network connectivity between cerebellar, control, and sensory networks, compared to ADHD. Clinically, higher MDT and FOT in state 2 were associated with physical anhedonia in SZ, while hyperactivity symptoms in SZ were associated with FOT in state 1. These findings show that psychiatric disorders are characterized by instability in brain network dynamics, with both shared and disorder-specific features. Our results also align with frameworks emphasizing that psychopathology arises from graded disruptions in interacting neural systems rather than discrete diagnostic categories. These dFNC features may serve as potential biomarkers for symptom dimensions in schizophrenia and ADHD.
Cognitive distortions are central to the maintenance of depression, as they bias information processing and negatively impact adaptive emotion regulation. As one manifestation of cognitive distortions, usage of absolutist words (e.g., always, never, must, completely) in written texts has been found to be indicative of underlying depression. Since absolutist word usage may allow important insights into maladaptive thinking patterns, it could be a relevant target for both monitoring and treating depressive symptoms. Therefore, we tested the relationships between absolutist word usage in spoken language with depression diagnosis, depressive symptom severity and current depressed mood. We recruited 144 age- and gender-matched participants with clinical depression (n = 48), subclinical depression (n = 48), and no history of depression (n = 48). By conducting smartphone-based ecological momentary assessments (EMA) three times daily for two weeks, participants provided ratings of depressed mood and speech samples, which included mood descriptions and mood-regulating statements. The Hamilton Rating Scale for Depression (HRSD) was administered at the end of the 2-week period to assess depressive symptom severity retrospectively. Group differences were calculated with ANOVAs, associations between depressed mood and absolutist word usage were evaluated with multilevel models, and the relationship between depressive symptom severity and absolutist word usage was calculated with regression models. Results showed more frequent absolutist word usage over the EMA phase in individuals with clinical depression compared to individuals with no history of depression. Furthermore, absolutist word usage was negatively associated with momentary depressed mood among individuals with elevated depressive symptoms. Additional analyses testing the temporal relationship showed that greater absolutist word usage was associated with higher levels of depressed mood after 12–24 h. Accordingly, absolutist word usage was positively associated with depressive symptom severity assessed after the 2-week period. Our results have several implications: First, absolutist word usage in spoken language appears to be an indicator of depression, which may be relevant for the optimization of depression assessment and monitoring approaches. Second, the finding that absolutist word usage was associated with lower depressed mood in the short-term, but higher depressed mood in the long-term provides important insights into the mechanisms of depression, and may help identify relevant treatment targets for clinicians. German Clinical Trial Registration DRKS00023670 on 19/01/2021 ( https://drks.de/search/en/trial/DRKS00023670 ).
Autism spectrum disorder (ASD) is a chronic neurodevelopmental condition linked to significant long-term health consequences. Although ASD is often diagnosed in childhood, many individuals remain undetected until adulthood. The estimated prevalence among adults is similarly high, approximately 11 per 1000 individuals. Anxiety disorders are more common in ASD individuals and may adversely impact quality of life. Overlap between ASD and anxiety symptoms can complicate diagnosis and access to proper treatments, and may account for the differences in reported prevalence between studies. Research on adult ASD in Iran is exceedingly scarce. Therefore, this study aimed to (i) investigate the current prevalence of comorbid anxiety disorders in autistic adults; and (ii) examine the association between autism-trait measures and anxiety symptoms. This descriptive-analytical cross-sectional study included 83 autistic adults from a neurodevelopmental clinic in Tehran (mean age: 26.53 ± 7.17 years; male-to-female ratio: 4.53:1). Data were obtained from participants’ prior records (AQ, RAADS-R, IQ), the Hamilton anxiety rating scale, and the SCID-5 interview. The current prevalence of GAD, SAD, panic disorder, and agoraphobia was 50.6
Over one million Chinese international students (CIS) are currently enrolled in higher education abroad, predominantly in Western universities. The volume of research on CIS mental health has increased steadily in recent years, with evidence indicating poorer outcomes compared to both domestic and other international student groups. However, comprehensive syntheses and understanding of this literature remain limited. We conducted a scoping review to map the evidence on CIS mental health in Western higher education settings, to examine the strength and gaps of the evidence base, and to inform future research and support provision. Based on a pre-registered strategy, we systematically searched MEDLINE, PsycINFO, Embase, ERIC, and CINAHL from inception to 10 December 2025. Grey literature was also searched (including PsycEXTRA, BASE, medRxiv, and PsyArXiv). Articles were reviewed for inclusion/exclusion by 2 authors. This scoping review integrates findings from 225 reports, examining three core areas: the prevalence of mental health issues, existing interventions, and factors influencing mental health and psychological well-being. Depression, anxiety, and psychological stress are the most commonly reported concerns, though prevalence estimates vary substantially. While some interventions exist, they are narrow in scope and lack evidence for effectiveness at scale. Factors associated with variation in mental health and psychological wellbeing among CIS include academic stress, social isolation, language difficulties, cultural adjustment, and inadequate institutional support. High-quality evidence on prevalence and intervention effectiveness remains limited. These findings underscore the need for more robust, culturally responsive support systems and interventions to address the mental health needs of CIS in Western higher education settings.
