IntroductionDespite stress being a critical component of burnout, few studies have investigated the relationship between burnout and aggressive behaviour. Therefore, the current study aims to verify whether states of exhaustion are associated with aggression.MethodsStructural equation models were constructed using data from a representative sample of 1027 young adults (Mage = 24.53), almost half of whom were men (n = 507). The models revealed the relationships between burnout, aggressive behaviour, emotion regulation strategies, risky alcohol consumption, stress, and adverse childhood experiences. ResultsAlthough there were minor differences in the pathways between men and women, both models showed a good fit for the data. Furthermore, among both men and women, the positive relationship between burnout and aggressive behaviour was mediated by maladaptive coping strategies and risky alcohol consumption. Interestingly, reliance on maladaptive emotion regulation strategies was also associated with increased depressive symptoms among women but not among men.ConclusionThe findings of this study reveal that aggressive behaviour is another negative consequence of burnout among young adults and highlight the importance of skills applied in responses to chronic stress. The implications of these findings and further results are discussed in relation to the existing literature.

ObjectiveThis study aims to validate the Czech-language Psychopathic Processing and Personality Assessment (PAPA) by examining its factor structure and psychometric properties in a non-forensic community sample in the Czech Republic.MethodsThe study included 1013 adult participants (51.73% male, 48.27% female) with an average age of 42.14 years (SD = 8), drawn from the general population of Czech parents with at least one child. Participants completed the PAPA, a 29-item self-report questionnaire. The sample was divided into two groups for exploratory (n=304) and confirmatory factor analysis (n=709). Data were analysed using Principal Component Analysis (PCA) and Confirmatory Factor Analysis (CFA) to identify and validate the factor structure.ResultsThe exploratory analysis suggested a three-factor solution comprising hostile attitudes, manipulativeness, and callous-unemotional traits, which was confirmed through CFA. The model demonstrated acceptable fit indices (CFI, RMSEA, SRMR), indicating a robust structure for both male and female participants. Internal consistency for the factors ranged from acceptable to good.ConclusionsThe validation of PAPA in Czech revealed a three-factor structure consistent with core psychopathy traits. This tool provides a reliable measure for assessing psychopathy in the Czech general population, highlighting cultural and sex-specific nuances in psychopathy assessment. Future research should explore the inclusion of the boldness dimension and validate the tool in forensic settings.

This study explored how cognitive emotion regulation strategies (CERS) relate to mental health and sleep quality in young adults and aimed to identify specific CERS associated with both. Self-measured methods were used in 1030 young adults. Participants completed the Pittsburgh Sleep Quality Index (PSQI), Cognitive Emotional Regulation Questionnaire (CERQ), Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory (BAI). Data were analysed using Spearman correlation and Structural Equation Modelling (SEM). Less adaptive CERS were significantly associated with poorer subjective sleep quality and with increased depression and anxiety symptoms. However, adaptive CERS were not significantly associated with sleep quality and depressive symptoms but showed a positive correlation with anxiety symptoms. SEM showed that catastrophising and self-blame were significantly positively associated with both mental health and sleep quality. These findings suggest that targeting specific CERS could be a practical approach to improving sleep quality and mental health.

Background: Electroconvulsive therapy (ECT) is a highly effective treatment for severe and treatment-resistant depression, yet concerns remain regarding its cognitive side effects. The study aimed to assess changes in cognitive performance in patients with depression undergoing ECT and to evaluate the trajectory of recovery after treatment. Materials and Methods: A total of 95 patients diagnosed with depression were assessed over a three-year period. Cognitive performance was measured at four time points: before treatment, prior to the fourth session, within three days after ECT completion, and for a subgroup of 31 patients also six weeks post-treatment. The Montreal Cognitive Assessment (MoCA) was used for initial screening, and the MATRICS Consensus Cognitive Battery (MCCB) was applied for detailed evaluation. Depressive symptoms were monitored using the Montgomery-Åsberg Depression Rating Scale (MADRS). Results: ECT led to significant improvement in depressive symptoms, with remission rates ranging from 60–80%. Initial cognitive decline was observed early in the treatment course, particularly in memory and new learning, but cognitive functioning improved as treatment progressed. At six weeks post-treatment, further recovery was evident, although cognitive scores remained below average baseline levels. Most short-term cognitive side effects resolved within weeks after ECT. Conclusion: ECT is a safe and effective intervention for severe depression, providing substantial symptomatic relief. While transient cognitive side effects occur, they are generally reversible, underscoring the importance of monitoring cognitive outcomes throughout treatment and follow-up.

BackgroundDementia is a leading cause of mortality worldwide, with its prevalence projected to rise sharply in the coming decades. Established risk factors include advanced age, hypertension, diabetes, obesity, smoking, excessive alcohol consumption, physical inactivity, social isolation, and depression. Increasing evidence suggests that vaccination-by preventing infections that may trigger or accelerate neurodegeneration-could play a protective role against dementia, though findings remain inconsistent.ObjectiveTo systematically review observational evidence on the association between influenza vaccination and the risk of developing dementia, with attention to demographic, social, and health-related moderating factors.MethodsThis systematic review, conducted in accordance with PRISMA 2020 guidelines, synthesized evidence from Scopus and Web of Science. Eligible studies were observational in design, employed validated dementia diagnoses, and reported demographic, social, or health covariates. Study quality was assessed using the Newcastle-Ottawa Scale.ResultsSeven studies, encompassing 9,866,019 participants, met the inclusion criteria. Six of these studies reported a significant association between influenza vaccination and a reduced risk of dementia. Protective effects were particularly evident with repeated vaccinations and among individuals with chronic comorbidities. Key moderating factors included age, sex, vaccination frequency, and specific health conditions.ConclusionsCurrent evidence suggest that influenza vaccination may confer a protective effect against dementia, especially in populations with chronic diseases who receive regular vaccinations. These results highlight the potential of influenza vaccination as a scalable, cost-effective public health measure to mitigate dementia risk and underscore the need for further high-quality longitudinal research.

Social media has become an integral part of everyday life and has been suggested as a contributing factor in the development and maintenance of eating disorders (EDs). This systematic review aimed to summarise current evidence on the association between social media use and eating disorders in young adults aged 18–30 years. Only studies in which the authors explicitly declare that they focus on eating disorders as diagnostic entities in relation to social media use were included. A systematic literature search was performed in March 2025 using Web of Science, Scopus, and PubMed. In total, 630 records were identified, of which seven studies met the inclusion criteria. Most studies employed cross-sectional designs, with one experimental study. Six out of seven studies reported a positive association between social media use and eating disorder symptomatology or diagnoses, while one study reported no significant association between social media use and eating disorder outcomes. Evidence consistently pointed to the role of appearance-focused content (e.g., thinspiration, fitspiration) and problematic social media use as factors associated with greater symptom severity and related psychological outcomes. Overall, social media use may represent a relevant factor in the development and maintenance of eating disorders in young adults. The findings may contribute to understanding potential risk and protective factors and inform future research directions. However, given the limited number and heterogeneity of studies, further research is needed. Until now, only a limited number of research reviews have focused specifically on social media use and eating disorders as diagnostic entities in young adults. This review summarizes previous research on this relationship in people aged 18 to 30 years. The available evidence suggests that social media use may play a role in the development and maintenance of eating disorders in young adults. More specifically, appearance-focused content, such as thinspiration and fitspiration, and problematic social media use may be linked to more severe eating disorder symptoms. However, only a small number of studies were available, and the studies differed in their methods and measures. More research is therefore needed to better understand this relationship.

Psychiatric intensive care units provide care for mental health patients in psychiatric crises, often involving violent behaviour. This study aimed to examine the ability of the Dynamic Appraisal of Situational Aggression (DASA) to predict violent acts of different proximal causes in patients. We collected 2467 DASA predictions from 352 patients who had committed 366 violent incidents. All incidents were recorded using a Modified Overt Aggression Scale (MOAS). Receiver operating characteristic (ROC) curve analysis was used to assess the DASA predictive values. DASA demonstrated an overall area under the curve (AUC) of 0.76 (95% confidence interval [CI] [0.72, 0.79]), with similar values for impulsive (AUC = 0.75, 95% CI [0.70, 0.81]) and psychotic (AUC = 0.75, 95% CI [0.70, 0.79]) aetiologies. Notably, the AUC for females was 0.80 (95% CI [0.75, 0.86]), indicating a particularly high predictive validity for women. We also observed that higher DASA scores predict higher incident severity assessed by MOAS scores (Spearman's rho = 0.13, p = 0.03). Most employed nursing interventions included de-escalation techniques (18%) and one-to-one nursing. In patients with high-risk scores, interventions also involved psychopharmacological or even coercive methods. The DASA shows satisfactory predictive validity for both psychotic and impulsive aetiological incidents and demonstrates better predictive validity for women. This study evaluated the predictive validity of DASA for different types of violent acts (psychotic, impulsive and predatory) in both sexes and implemented a set of corresponding interventions. These interventions should be customised to address the specific risk factors in each patient.

Length of stay (LoS) is a critical parameter of inpatient forensic treatment functioning. Inpatient forensic LoS in Czechia varies across hospitals with the number of patients per 100,000 inhabitants and the treatment duration. We aimed to analyse these inter-hospital differences and provide relevant sociodemographic and treatment-related data. We collected descriptive parameters from 841 forensic inpatients from 13 hospitals in Czechia, with follow-up data collection after 6 months (N = 800). Data from eight hospitals with > 50 patients (N = 765) were entered into linear regression analyses with subsequent resampling to identify differences in LoS associated with index offence, diagnosis, and treatment type, thereby highlighting interhospital variations. The cohort comprised predominantly males (mean age, 41.84 years; standard deviation [SD] 3.63) with extended mental health histories; the mean main diagnosis length was 13.2 years (SD 12.18). Most inmates committed violent offences, with psychotic, substance use, or paraphilic disorders predominating. Family contact remained common despite the patients’ poor socioeconomic status. The mean LoS was 1,327.58 (SD 1642.41) days. We observed significant differences in LoS among patients from the same diagnostic group. Within the whole system, patients with substance abuse disorders, psychotic disorders, and intellectual disabilities stayed for 760, 1490, and 2441 days, respectively. Violent index offences increased LoS in most hospitals, as did sexual offences, but “other” minor criminal offences (non-violent, non-sexual) were associated with increased LoS only in some hospitals. Sex offender treatment significantly affected LoS in some hospitals, while enrolment into substance use programmes shortened it. Our study revealed significant inter-hospital variations in LoS associated with index offences, diagnoses, or treatment programs, which could be related to previously unrecognised institutional factors. Regular evaluation of treatment outcomes and implementation of standardised guidelines across the entire system is necessary to balance these differences. The insights provided into inpatient treatment in Czechia can be used to guide policy and practice improvements, enhancing the quality of forensic psychiatric care and ensuring the rights and well-being of the patients. The study addressed the knowledge gap existing in the available literature regarding previously unrecognised factors influencing the LoS at the system “mezzo” level.

Introduction:Limited research has explored the sociodemographic profiles, institutional behaviours, and treatment needs of women receiving forensic psychiatric care, particularly in Eastern Europe. Existing evidence suggests that women differ from men in several clinically significant ways that impact service delivery, treatment strategies, and overall care. Methods:A cross-sectional design was employed involving 85 women and 753 men across 14 forensic psychiatric facilities in the Czech Republic. Data were collected at two-time points, six months apart, using the Health of the Nation Outcome Scale-Secure (HoNOS-secure) and the Modified Overt Aggression Scale (MOAS). Gender differences in psychiatric diagnoses, length of stay (LoS), aggression, and unmet needs were statistically analysed. Results:The mean age of women was 45.08 years, compared to 41.43 years for men. Women had a significantly shorter average LoS (893.27 days; SD 116-3935) than men (1358.36 days; SD 28-15311). Women were more often diagnosed with psychotic and substance use disorders, had higher rates of violent index offences, and were 2.33 times more likely to receive antipsychotic medications. Although women initially demonstrated higher MOAS scores, they showed significant improvement over time. Both genders exhibited reduced security needs at follow-up. Nonetheless, high levels of unmet needs remained, particularly among women. Conclusions:The findings emphasise the importance of gender-responsive approaches in forensic psychiatric care. Establishing specialised forensic units for women is crucial to addressing their distinct clinical and psychosocial needs, enhancing treatment outcomes, and reducing recidivism. This study identifies critical service delivery gaps and reinforces the need to develop targeted interventions tailored to women in forensic settings.

Background:Nutritional psychiatry has established that nutrient-dense diets rich in fruits, vegetables, whole grains, and lean proteins are associated with lower rates of depression and anxiety, while diets high in refined sugars and saturated fats predict greater psychological distress. Although emotion-regulation strategies are known to influence eating behavior, evidence on their role in shaping overall diet quality remains scarce, particularly in Central and Eastern European populations. Young adulthood (18-30 years) represents a critical developmental stage in which both mental health vulnerabilities and long-term dietary patterns consolidate, yet no prior study has examined how discrete cognitive emotion-regulation strategies relate to both global diet quality and specific eating behaviors in Czech young adults. Methods:In the Czech Republic, we conducted a cross-sectional survey of 1,027 young adults (507 men, 520 women; mean age = 24.6, SD = 3.3 years) recruited via quota-based convenience sampling matched to the 2021 census on age (18-30 years), sex, education, and region. Data were collected in three 60-min online sessions. Participants completed validated Czech measures of depression (BDI), anxiety (BAI), psychological distress (SCL-90), burnout (Shirom-Melamed Burnout Measure), and nine CERQ subscales-all demonstrating α ≥ 0.89 in prior validations and α ≥ 0.79 in our pilot (N = 50). Diet quality was assessed using a 30-item Czech FFQ (pilot α = 0.81), from which Diet Quality Index International (DQI-I) scores were computed. Eating behaviors were measured with the 31-item Czech Adult Eating Behavior Questionnaire (AEBQ; α_total = 0.79). We used stepwise multiple regression with all variance inflation factors < 2.0 to identify psychological variables associated with DQI-I and with "food-approach" versus "food-avoidance" behaviors, minimizing overfitting. Results:In exploratory stepwise regression models (all variance inflation factors < 2.0), the DQI-I model explained a small proportion of variance (Adj R2 = 0.024; f2 = 0.025). Within this model, higher rumination was positively associated with diet quality (B = 0.34, p < 0.001), while depressive symptoms were inversely associated with diet quality (B = -0.09, p = 0.001). The AEBQ model accounted for a modest but meaningful share of variance (Adj R2 = 0.155; f2 = 0.183). In this model, anxiety, catastrophizing, and "focus on the positive" were positively associated with food-approach behaviors (all p < 0.001), whereas positive reappraisal and acceptance negatively associated with dysregulated eating (p < 0.01). These associations should be regarded as tentative and hypothesis-generating, given the exploratory design and modest variance explained. Conclusion:This study is the first census-matched study of Czech young adults to examine emotion-regulation strategies in relation to both diet quality and eating behaviors. These findings reveal complex and partly counterintuitive associations-for example, rumination was linked to healthier diet quality, while some ostensibly adaptive strategies coincided with more dysregulated eating. These results should be interpreted as exploratory and hypothesis-generating, underscoring the potential relevance of cognitive-emotional mechanisms for future nutritional psychiatry interventions. Integrating approaches that address maladaptive strategies such as catastrophizing with dietary guidance may represent a promising direction for prevention and health-promotion efforts but requires confirmation in longitudinal and experimental studies.

While mitochondria provide critical energy resources, mitochondrial dysfunction can lead to both metabolic and neurodegenerative disorders. Primary mitochondrial disorders (e.g., Leigh syndrome) are uniformly associated with profound neurodegeneration. Recent studies have also implicated mitochondrial dysfunction as a central feature of progressive neurodegenerative diseases, notably Alzheimer's disease, Parkinson's disease, Amyotrophic Lateral Sclerosis, and Huntington's Disease. In addition to its profound impact on metabolic disease, the glucagon-like peptide-1 receptor agonist, semaglutide, has significant neuroprotective features and may limit the progression of one or more of these disorders. These observations might be explained at least in part by the impact of this drug on mitochondrial function and energy production. Collectively, these observations highlight disrupted energy homeostasis as a critical feature of neurodegenerative disease and suggest novel targets for the development of much-needed new neuropharmaceutical strategies.

Abstract The intricate links between protein misfolding and psychiatric disorders have drawn increasing attention in recent years. Several published studies have highlighted the contributions of misfolded proteins to the pathophysiology of conditions that include schizophrenia, depression, Alzheimer’s disease, and prion diseases. Recent breakthroughs in computational approaches, exemplified by the artificial intelligence application AlphaFold 2, have enabled us to predict protein structures with remarkable precision, resulting in unprecedented insights into the molecular mechanisms driving psychiatric illnesses. However, challenges remain in the application of computational power and its accuracy, particularly given the unrealized potential of quantum computing (QC). This commentary examines current advances in protein-folding and its impact on psychiatric research, addresses several of the ongoing challenges, and discusses the future promise of QC for deepening our understanding and advancing the treatment of neuropsychiatric disorders.

Background: Ultrabrief stimulation in electroconvulsive therapy (ECT) using a 0.25 or 0.30 ms pulse width markedly reduces the charge required to reach the seizure threshold (ST) and cognitive side effects. It is not known whether further reduction of pulse width to 0.15 ms is advantageous. Methods: Thirty-seven patients were randomized to ST titration at the first session applying right unilateral (RUL) ECT with either a 0.15 or 0.30 ms pulse width and were titrated again in the second session using the alternative pulse width. All subsequent treatments used the pulse width applied in the second titration session, administering RUL ECT, starting at 6xST. The primary outcome was difference between the pulse widths in ST at the two titration sessions. Exploratory analyses examined differences in seizure duration and postictal time to recover orientation (TRO), averaged across all ECT sessions from the third onwards. Other exploratory analyses examined clinical improvement and retrograde amnesia for autobiographical information and other neuropsychological functions following the ECT course. Results: In the first titration session, ST was significantly lower with the 0.15 ms than 0.30 ms pulse width. ST significantly increased when re-titrating with the 0.30 ms pulse width and significantly decreased when retitrating with a 0.15 ms pulse width. There were no differences between the pulse width groups in clinical improvement, TRO, or neuropsychological measures. Conclusions: Ultra-ultrabrief stimulation with a 0.15 ms pulse width is more efficient in seizure induction than a 0.30 ms pulse width. Comprehensive studies should determine whether ultra-ultrabrief stimulation replaces ultrabrief stimulation as a default parameter for ECT.

IntroductionThe issue of the impact of religion and spirituality on mental health is a phenomenon which has recently become increasingly more accentuated. Despite the attention given to the topic, many questions still remain as to whether and how religion and spirituality affect a person’s mental wellbeing. In the text below, we have focused on examining the relationship between religion and spirituality and mental health among young adults in the Czech Republic. Research also explored the idea that forgiveness can be viewed as a component of religion or spirituality.Materials and methodsThe research project was executed in close cooperation with STEM/MARK, a renowned data collection agency. The methodological framework was constructed with a dual focus: leveraging standardized questionnaires to ensure data reliability and comparability while also incorporating tailored questions that delve into the participants’ socioeconomic status (SES) and background details. The study unfolded across four online sessions, a format chosen for its convenience and effectiveness in facilitating participant engagement while accommodating our respondents’ diverse schedules. The total sample approached comprised of 270 young adults that expressed certain form of religiosity.ResultsForgiveness and the depth of one’s personal religious or spiritual history emerged as the most influential factors. Forgiveness was significantly associated with an increase in self-blame (positively), and decrease in refocusing, planning (both negatively), and putting things into perspective (negatively) (Beta = 0.25, Beta = −0.06, and Beta = −0.16, respectively). In contrast, a deeper personal religious history was positively associated with self-blame, rumination, and refocusing (Beta = 0.22, Beta = 0.13, and Beta = 0.15, respectively).ConclusionThe finding that forgiveness may be a risk factor associated with regularly elevated depressive symptoms, stress, and maladaptive coping strategies such as self-blame and ruminating over problems, while negatively affecting physical, psychological, and environmental quality of life, clearly points to the need to examine the inner aspects of individual religions and spiritualities. These findings suggest that religious and spiritual beliefs may play a key role in how people experience and manage the emotional burdens and difficulties of life.

Mitochondria, the cellular powerhouses with bacterial evolutionary origins, play a pivotal role in maintaining neuronal function and cognitive health. Several viruses have developed sophisticated mechanisms to target and disrupt mitochondrial function which contribute to cognitive decline and neurodegeneration. The interplay between viruses and mitochondria might be traced to their co-evolutionary history with bacteria and may reflect ancient interactions that have shaped modern mitochondrial biology.

Background: Secure forensic hospital treatments are resource-intensive, aiming to rehabilitate offenders and enhance public safety. While these treatments consume significant portions of mental health budgets and show efficacy in some countries, their effectiveness in Czechia remains underexplored. Previous research has highlighted various factors influencing the likelihood of discharge from these institutions. Notably, the role of sociodemographic variables and the length of stay (LoS) in the context of forensic treatments has presented inconsistent findings across studies. Methods: The study, part of the ‘Deinstitutionalization project’ in Czechia, collected data from all inpatient forensic care hospitals. A total of 793 patients (711 male, 79 female and 3 unknown) were included. Data collection spanned 6 months, with tools like HoNOS, HoNOS-Secure, MOAS, HCR-20V3 and AQoL-8D employed to assess various aspects of patient health, behaviour, risk and quality of life. Results: The study revealed several determinants influencing patient discharge from forensic hospitals. Key assessment tools, such as HoNOS secure scores and the HCR-20 clinical subscale, showed that higher scores equated to lower chances of release. Furthermore, specific diagnoses like substance use disorder increased discharge odds, while a mental retardation diagnosis significantly reduced it. The type of index offense showed no influence on discharge decisions. Conclusion: Factors like reduced risk behaviours, absence of mental retardation diagnosis, social support and secure post-release housing plans played significant roles. The results underscored the importance of using standardized assessment tools over clinical judgement. A standout insight was the unique challenges faced by patients diagnosed with mental retardation, emphasizing a need for specialized care units or tailored programmes.

Electroconvulsive therapy (ECT) is an important treatment modality in psychiatry, considered to be the most effective option for pharmaco-resistant affective and psychotic disorders. Despite its great efficacy, it still remains a rather controversial method, which hinders its full potential. It is feasible to say that in part, this controversy is caused by a largely negative image of ECT displayed through media. The depiction of ECT in movies has been studied and well documented in the past. The aim of our study was to provide an overview of how ECT is represented in video games - a form of media where ECT representation has been overlooked in scientific literature so far. As with movies, most of these portrayals are negative, depicting ECT as an obsolete, aggressive or torturous treatment method.