Unmet need for health psychologists is growing internationally. However, methodologically consistent and regular workforce data is lacking for long-term, evidence-based workforce planning. A two-armed, mixed-methods study (PsycH) of health psychologists was conducted across all 20 health districts in New Zealand (May 2022-January 2023). Arm 1 had 115 individual psychologists responding, while 17 professional leaders responded to Arm 2. Overall, PsycH found 126.14 full-time equivalent (FTE) psychologist positions across 34 categories of physical health services. The psychological workforce grew by 31.60 FTEs over the last 5 years, but 73 new positions worth 70.80 FTEs are needed to meet projected demand over the next 5 years. Psychologists reported high levels of job satisfaction but persistent systemic barriers to sustainable workforce development. PsycH highlighted the importance of robust and regular workforce data in facing growing levels of unmet need for psychologists in physical health settings in New Zealand, with similar challenges seen internationally.

Background Medically unexplained physical symptoms (MUPS) commonly present across medical disciplines and can be disabling for patients. Despite this, MUPS are often poorly managed, causing distress, strained doctor-patient relationships, and higher healthcare costs. Inadequate medical training has been recognised as contributing to these poor outcomes. The first of its kind in New Zealand, this study assessed the knowledge, attitudes, and exposure to MUPS during medical school. Methods Final-year University of Auckland medical students completed an anonymous online survey including multiple-choice questions, Likert-scale items, and optional free-text comments. Descriptive statistics were used to analyse the data. Results 84 of 281 (30%) eligible students completed the survey. Despite its limited presence in the medical curriculum, approximately 70% of respondents could not confidently recall having received formal education on MUPS. Among those who could recall such teaching, roughly two-thirds identified clinical psychiatry rotations as the provider. The great majority of respondents endorsed further need for education on clinical recognition (71/84) and management (75/84) of MUPS and disagreed with the proposition that patients with MUPS receive satisfactory healthcare. Students also perceived MUPS as relatively common and associated with moderate functional impairment. Conclusions Medical students perceive MUPS as common, functionally impairing, and insufficiently addressed in the medical curriculum. Interdisciplinary teaching that emphasises communication skills and includes biopsychosocial explanatory models may better prepare junior doctors to assess and manage patients with MUPS. Clinical trial number: Not applicable

Background Electronic gaming machines (EGMs) are disproportionately associated with gambling-related harm, yet qualitative research exploring these harms from the perspectives of active EGM users remains limited. Understanding how harm is experienced and sustained is critical for informing population-level public health responses. Methods A qualitative study was conducted using semi-structured, in-depth interviews with twelve regular EGM users in New Zealand. Participants were recruited through purposive sampling and were required to have engaged in EGM gambling at least weekly in the past 60 days. Interviews were audio-recorded, transcribed verbatim, and analysed using the framework method to enable systematic comparison across cases. Analysis was guided by a social determinants of health lens. Results Six interrelated themes were identified: social and environmental influences, behavioural and psychological reinforcement, emotional and mental health impacts, financial harm and broader life consequences, barriers to help-seeking, and perspectives on harm minimisation. Participants described how the accessibility of EGMs, immersive venue environments, and reinforcing structural machine features interacted with emotional vulnerability and social context to sustain prolonged gambling. Harms extended beyond financial loss to include relationship disruption, psychological distress, and reduced wellbeing. Help-seeking was often constrained by stigma, limited awareness of services, and a reliance on self-regulation strategies that frequently deteriorated over time. Conclusions Findings highlight the limitations of individual-focused harm minimisation approaches and demonstrate the need for population-level strategies addressing the structural and commercial determinants of gambling harm. Strengthening regulation, reducing accessibility, and improving public awareness may more effectively mitigate EGM-related harm and associated inequities.

INTRODUCTION:Despite growing interest in microdosed psychedelics, clinical trial evidence remains limited. We present daily mood, subjective perception of effects, and pharmacokinetics from an 8-week regimen of microdosed lysergic acid diethylamide (LSD) as a treatment for major depressive disorder in an open-label trial in which participants reported a mean symptom reduction of 60%. METHODS:Participants took 16 sublingual LSD doses: 8 μg onsite, with bloods collected at eight time-points, then twice weekly at home with titration (6-20 μg). Pharmacokinetic parameters were estimated using non-compartmental and compartmental modelling. Daily questionnaires were used to assess depression severity with the self-reported Hamilton Depression Rating Scale (HAMD6), and mood with visual analogue scales (VAS). Drug effects were recorded with VAS scales on each dosing day. Linear mixed models were used to compare dosing days to one- and two-day post-dosing, and to identify linear trends (tolerance/sensitisation) of drug effects. RESULTS:Nineteen participants (males n = 15, 79%) received the intervention. Daily VAS indicated increased scores of mood-related states (e.g., more creative, happier) on dosing days (p = 0.009 to 0.039), but not in depression (p = 0.291). There was no indication of tolerance or sensitisation (p > 0.081). Non-compartmental AUC0-tlast was 836 ± 319 pg.h/mL, Cmax 212 ± 77.7 pg/mL and Tmax 1.17 ± 0.56 h. DISCUSSION:Results suggest short-term improvements in mood following microdosed LSD in people with depression, warranting confirmation in controlled trials. It provides the pharmacokinetic parameters of 8 μg of LSD in a sample of people with depression and indicates no tolerance or sensitisation to repeated microdoses of LSD, despite incremental dose titration.

IntroductionMajor depressive disorder (MDD) is a leading cause of global disability. Current treatments are limited by poor efficacy in approximately one-third of patients. Neuroinflammation may be an underlying mechanism of MDD and represents a novel target for pharmacological therapy. This study aimed to investigate the effects of a putative centrally acting anti-inflammatory agent, low-dose naltrexone (LDN), in MDD.MethodsPatients with MDD experiencing moderate depressive symptoms and receiving antidepressant treatment were randomized to receive 12 weeks of LDN (up to 4.5 mg per day) or 12 weeks of inactive placebo. The primary outcome measure was the Montgomery-Asberg Depression Rating Scale (MADRS) at 12 weeks, analyzed using a linear mixed-effects model adjusted for baseline.ResultsThirty-seven patients were randomized. At 12 weeks, MADRS scores (M ± SD) were reduced by 10.5 ± 5.6 in the LDN group and 9.8 ± 5.9 placebo group; with no difference between groups (p = 0.97). LDN did not affect high-sensitivity C-reactive protein (hsCRP) levels or exploratory measures of depression, behavioral activation, quality of life, sickness symptoms and mood. There was no evidence that baseline hsCRP modified the effect of LDN on MADRS score.DiscussionAdjunctive LDN does not appear to alter depressive symptoms in moderate MDD. Larger studies are warranted to evaluate LDN in a population with a higher likelihood of neuroinflammatory pathology, such as those with severe, treatment-resistant MDD or comorbid inflammatory conditions. Future studies should utilize stratification tools that are more sensitive and specific to neuroinflammation than hsCRP.Clinical Trial Registrationhttps://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=383741&isReview=true, identifier [ACTRN12622000881730].

OBJECTIVES:To describe detected delirium prevalence and current delirium-related practices in Australian and New Zealand healthcare sites. METHODS:This study was a sub-analysis of Australian and New Zealand data from an international cross-sectional survey conducted on World Delirium Awareness Day 2023. Delirium was identified using existing clinical practices on participating wards. RESULTS:Across 257 wards of varying specialties and acuities, detected delirium prevalence was 16% (n = 637/4033) at 8:00 AM and 16% (n = 609/3836) at 8:00 PM. Delirium assessment rates were 63% (n = 4033/6369) at 8:00 AM and 63% (n = 3836/6091) at 8:00 PM. Most wards (93%) used validated assessment tools, most commonly 4AT and CAM. Just over half (53%) assessed for delirium at least daily, whereas 37% only assessed in response to the sudden changes in consciousness or clinical condition. Written delirium protocols were common (91%). Non-pharmacological strategies were widely implemented, particularly ensuring adequate fluids (87%), mobilisation (84%) and pain management (84%). Frequent use of pharmacological interventions was often reported, particularly antipsychotics, including risperidone (36%), haloperidol (35%) and quetiapine (31%). Key perceived barriers to implementation of evidence-based delirium care were staff shortage (70%), lack of time to educate and train staff (53%) and missing knowledge (49%). CONCLUSIONS:In Australia and New Zealand, delirium assessment practices have improved over time. Non-pharmacological strategies are widely used; however, antipsychotic use remains substantial. Workforce constraints, education gaps and system pressures may contribute to variability in delirium care delivery. Addressing these factors, alongside engagement with carers, may support further improvements in care. Ongoing surveillance through repeated surveys would help monitor trends in delirium care over time.

IntroductionColours have been used as a complementary aid in the treatment of physical and mental disorders for centuries. There is substantial anecdotal evidence supporting the use of colours in therapeutic contexts, but scientific evidence remains limited. This review aimed to map existing literature on colour preferences among individuals with common mental health disorders, examine patterns across different diagnostic categories, and identify differences compared to healthy participants.MethodsA comprehensive literature search was conducted in four databases. This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) and the Joanna Briggs Institute (JBI) guide for scoping reviews. Studies that assessed the favourite or preferred colour of individuals diagnosed with mental health disorders were reviewed. The methodological quality of the included studies was assessed using the Quality Assessment with Diverse Studies (QuADS) and Elliot’s guide for evaluating the quality of colour and psychological research.ResultsA total of 16 studies met the inclusion criteria. Colour preferences were generally assessed using the Lüscher colour test, coloured cardboards, or digital colour representation. Distinct preferences for colours were observed across diagnostic categories—blue was preferred among those with depressive disorders, grey among those with anxiety-related disorders, and black among those with schizophrenia. Achromatic colours such as black or grey were not preferred by healthy participants. Healthy populations exhibited geographical variation in colour preferences, with European participants tending to prefer blue, while Asian participants preferred red and yellow. In contrast, no clear geographical patterns were observed among individuals with mental health disorders; preference patterns varied according to the diagnostic category.ConclusionColour preferences differed noticeably across various categories of common mental health disorders and from those of healthy individuals.Systematic review registrationThe scoping review protocol was registered in the Open Science Framework and the URL: https://osf.io/khr8q.

College students commonly experience mental health concerns but may not seek treatment. Mental health literacy (MHL) may help to explain the perspectives college students hold and their help seeking behaviors. However, there are challenges with the measures used to assess MHL. We investigated college student perception of mental health, mental health challenges, and mental health treatments in preparation for measurement development. A sample of 127 college students was recruited from a four-year institution in the Southeastern United States. Participants completed survey measures of depression and anxiety; questions about the knowledge, importance and conceptualizations of MHL; symptoms of a variety of mental health conditions (including mania and schizophrenia); preferences for treatment; awareness of resources; and willingness to seek help. High levels of depression and anxiety were found in this sample, who also believed they had adequate levels of MHL (59.8 on a scale of 1-100). Findings indicated positive conceptualizations of MHL and a willingness to seek support from a variety of professional and non-professional sources. However, the results showed that college students lacked knowledge about conditions beyond depression and anxiety, and treatments available. Future development of an instrument used to measure MHL requires a nuanced approach. Results suggest that college students are lacking in information about symptoms, treatments, and supportive care for a variety of mental health conditions. Additionally, results suggest that MHL is limited to understanding of conditions such as depression and anxiety. These results indicate that more education around MHL for college students is necessary.

The pathophysiology of neuroinflammation in psychiatric conditions remains poorly understood, highlighting the need for non-invasive tools that can measure neuroinflammation in vivo. We explored advanced diffusion-weighted MRI techniques for detection of low-level neuroinflammation induced by typhoid vaccine, with potential applications to psychiatric disorders. Twenty healthy volunteers (10 males, median age 34, range 18-44 years) participated in a randomized, placebo-controlled, crossover design study. Participants underwent MRI before and after receiving placebo or vaccine in alternating sessions, separated by a washout period. Diffusion tensor (multi-shell and single-shell), diffusion kurtosis, and neurite orientation density and dispersion imaging parameter maps were generated. Probabilistic tractography investigated differences in tract volume, fractional anisotropy (FA), and mean diffusivity (MD) of the tracts. Thirteen tracts and 15 regions were analyzed using a region-of-interest approach entered into linear mixed models to evaluate treatment effects. A treatment effect was observed on white matter tracts derived from XTRACT, with a global reduction in MD (p=.040). White matter tracts-of-interest showed increased axial kurtosis (p<.001) while grey matter regions-of-interest demonstrated increased mean and radial kurtosis (both p=.038). Additionally, several correlations were found between the inflammatory marker interleukin (IL)-6 and diffusion parameters. Our findings demonstrate that diffusion-weighted MRI may be sensitive to inflammation-induced microstructural changes in the brain. Future studies should integrate complementary techniques and clinical assessments to deepen our understanding of inflammatory pathophysiology and its implications for health outcomes in clinical populations.

Background Cytokines in first-episode psychosis (FEP) appear to be activated as part of an Inflammatory Response System (IRS) or a Compensatory Inflammatory Response System (CIRS) and have been proposed as clinical (state and trait) markers of psychosis. Antipsychotic medication normalizes the IRS/CIRS ratio despite a predominant activation of the IRS. The current study examined blood levels of IRS/CIRS cytokines proposed as clinical markers in symptomatic medicated patients with FEP. We screened all co-diagnoses and immunomodulating factors that have been linked to cytokine changes to increase the accuracy of findings. Methods We compared cytokines (n = 16) levels in the blood serum of patients with FEP (n = 20) recruited from a specialized FEP clinical service with a matched (age, gender, body mass index) group of healthy control subjects (HC)( n = 20). We screened for tobacco smoking, cannabis use, medications, and the absence of fever. Best-fitting regression models were used to identify differences in FEP vs HCs per diagnosis and additional variables of age, gender, and BMI. We correlated cytokine levels to Positive and Negative Symptoms Scale (PANSS) scores and antipsychotic load, recorded as chlorpromazine equivalents. Results We found elevated levels of IRS (IL-2 and IL-6), and reduced levels of IRS (IL-1, IL-8, IL-12), and CIRS (IL-4) in FEP vs HC. No significant differences in the IRS/CIRS ratio or a correlation between cytokine levels and PANSS scores were found. Lower levels of IL-2, IL-6 and IL-8 correlated to higher amounts of antipsychotics. Conclusion Our study on well-controlled moderately symptomatic patients with FEP taking antipsychotic treatment found that the IRS/CIRS ratio was not altered, while some alterations in cytokine levels were found. IL-2 and IL-6 remain elevated despite the immune-modulatory action of the antipsychotic agents; we suggest they could be used as screening tools for either trait (IL-6) and/or state (IL-2) markers of psychosis, in combination with C-reactive protein, to identify people with FEP that could potentially benefit from an adjuvant anti-inflammatory therapy alongside antipsychotics. Clinical trial registration number: Not applicable

Background: Subthreshold depression (sDep) and anxiety (sAnx) are common conditions and are associated with significant suffering, impaired functioning, increased healthcare utilisation and economic costs. Furthermore, they are risk factors for crossing the clinical threshold and developing mental health disorders. Subthreshold conditions are associated with long-term conditions (LTCs). This scoping review aimed to explore the identification and management of sDep and sAnx in primary care for patients with LTCs. Methods: We conducted a scoping review, following the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis. Medline, PsycInfo, CINAHL and International Pharmaceutical Abstracts were searched for articles prior to September 2023. We included studies written in English that were conducted among the adult population. All studies that aimed to identify and manage sDep and anxiety in patients with LTC in primary care have been included. Results: Thirty-three articles were included in this scoping review, of which seven studies incorporated an intervention component for sDep and sAnx in patients with LTCs. A variety of definitions and screening tools were used to identify sDep and sAnx. Problem-solving therapy (PST) and behavioural activation (BA) were the most common intervention components and showed promising results. Limitations: We excluded studies that did not explicitly state the terms 'subthreshold', 'subclinical' or 'subsyndromal' depression or anxiety which may be relevant. Conclusion: There is currently limited evidence regarding the identification and management of sDep and sAnx in patients with LTCs, warranting further research.

This scoping review aims to understand the available research and the quality of evidence about the cost-effectiveness of mindfulness-based interventions when applied to the medical student context. There is considerable literature pertaining to the application of mindfulness-based interventions in this context. However, the links between cost and effectiveness need to be established to ensure the relative integrity of these therapeutic systems. The participants included in the study were medical students (undergraduate and postgraduate). The concept under inspection concentrated on mindfulness-based interventions' cost-effectiveness, and the context was defined within the medical education setting—exclusion criteria required focusing on empirical studies published in peer-reviewed English language journals. Initially, a search protocol using the SPIDER system (Sample, Phenomenon of Interest, Design, Evaluation, Research type) was employed, followed by the development of a search algorithm. The literature search employed seven online databases, and the quality of evidence revealed within the final articles was analyzed. A summary table was developed classifying the first author, year of study, research design, cost and effectiveness. More specifically, the cost was evaluated in terms of financial outlay, acquisition of resources, and time involvement. In addition, effectiveness was determined by the impact of the intervention on students’ well-being and learning. A final review of 12 English language articles was conducted. The various costs identified included financial outlay on specialist personnel, venue provision, acquisition of measurement instruments, and time spent on the intervention. In reference to effectiveness, the evidence from the randomized or nonrandomized control studies indicated reduced perceived stress scores, reduced anxiety, alleviation of depression, and improved psychological health with some indication of improved learning management skills. Two nonrandomized cohort studies reported positive changes in levels of exam-induced salivary cortisol concentration. This scoping review revealed that no studies had comprehensively linked the costs of the intervention with purported levels of effectiveness. Future research needs to itemize the costs of the intervention and explicitly assess their links to effectiveness, such as well-being and learning.

Major depressive disorder (MDD) affects approximately 5 % of the global population. Classic psychedelics have shown promise in treating various mental health disorders. This study evaluated the feasibility and tolerability of an 8-week regimen of microdosed lysergic acid diethylamide (LSD) as a treatment for major depressive disorder in an open-label phase 2A trial (LSDDEP1). Nineteen participants (15 male), most of whom were taking an antidepressant medication (n = 15), took 16 doses of LSD (8 μg initially, then 6-20 μg twice weekly at home), with the first dose administered in the clinic. We assessed tolerability through withdrawal rates due to adverse events and feasibility by clinic visit attendance. Safety measures included adverse events, blood laboratory tests, electrocardiography (ECG), and echocardiography. Depression was measured using the Montgomery-Åsberg Depression Rating Scale (MADRS). No serious or severe adverse events and clinical alterations in safety measures were observed, being this the first study to evaluate valvulopathy after repeated psychedelic administration in humans. One participant withdrew due to experiencing anxiety when dosing; all scheduled clinic visits were attended. MADRS scores were reduced by 59.5 % at the end of the intervention and were sustained for up to six months. Improvements were also noted in anxiety, rumination, stress, and quality of life. While limited by an open-label design and small sample size, this study provides preliminary evidence supporting the safety and feasibility of treating moderate depression with microdosed LSD and underscores a need for further randomised controlled trials. Trial registration: ANZCTR, ACTRN12623000486628 (12 May 2023).

INTRODUCTION:Considerable evidence suggests a pathophysiological role of neuroinflammation in psychiatric disorders. Lumbar puncture and positron emission tomography (PET) show increased levels of inflammation in psychiatric disorders. However, the invasive nature of these techniques, as well as their expense, make them undesirable for routine use in patients. Electroencephalography (EEG) is noninvasive, affordable and shows potential as a clinical tool for detection of neuroinflammation. METHODS:In this randomized, crossover design, placebo-controlled, double-blind study, typhoid vaccine was administered to 20 healthy volunteers to induce a low level of neuroinflammation. EEG was recorded before and after placebo/vaccine administration during resting-state and during performance of the Attention Network Test (ANT). Resting-state EEG was analyzed using spectral power analysis, and time-frequency analysis was used for the EEG from the ANT. Behavioral data were assessed using linear mixed models and Spearman's correlations. RESULTS:Behavioral results from the ANT showed no decrement in performance following the vaccine, consistent with previous studies. During eyes-open resting, there was a relative decrease in right-frontal delta power in the vaccine condition compared to placebo. There was a trend toward greater alpha power suppression in the alerting response of the attentional network; however, this finding did not reach significance. CONCLUSION:Decreased resting-state delta power may reflect an unpleasant internal state conferred by the vaccine. Inflammation did not significantly affect attention networks. The absence of significant alterations may be due to an insufficient inflammatory response. Further studies are needed to assess the feasibility of EEG as a technique for detection of neuroinflammation.

Background Subthreshold depression and anxiety are common, affecting up to 24 % of people over their lifetime and are often associated with long-term conditions. Community pharmacists, who often have an established relationship with people who have long-term conditions, are well placed to identify and address subthreshold depression and anxiety and reduce the risk of progression to clinical mental health disorders. Methods Semi-structured individual qualitative interviews were conducted with community pharmacists to explore their perspectives on a pharmacy service for long-term condition patients with subthreshold depression and anxiety. Interviews were audio recorded, transcribed in intelligent verbatim and analysed using a General Inductive Approach. Results Eleven purposively selected community pharmacists from diverse backgrounds were interviewed. Four main themes were identified, each with several subthemes. These related to existing support mechanisms for delivering long-term condition and mental health services in community pharmacies, pharmacists' perceptions and attitudes toward service delivery, barriers and facilitators to service implementation, and the design and implementation of a service. Conclusions This is the first study to explore community pharmacists' perspectives on a pharmacy intervention for long-term condition patients with subthreshold depression and anxiety. Overall, community pharmacists expressed positive attitudes toward delivering an intervention for people with long-term conditions and subthreshold depression and anxiety. Future work would involve taking a co-design approach to developing and evaluating such an intervention.

Across the globe, countries are facing an ageing boom, with the proportion of the older adult population growing compared to younger age groups because of increased life expectancy and declining birth rates. Along with the ageing boom, there is increased interest in the wellbeing of older adults. Healthy ageing and social frailty are two constructs that have emerged in studying older adults and their quality of life. In this paper, we critically review salient literature defining and describing healthy ageing and social frailty, and in doing so develop an argument that shows how these two constructs are intertwined. Our aim is to develop a model showing how the two constructs deplete, annul, or augment each other. We propose that this theoretical treatise could inform future research in the field by highlighting and classifying the complex array of factors that influence and underpin the manifestation and function of the two phenomena.

Background: Depressive disorders affect approximately 280 million globally, with many finding treatments ineffective or limited by side effects. Growing evidence suggests that psychedelic therapies may help alleviate depressive symptoms. Among these, lysergic acid diethylamide (LSD) microdosing shows promise for major depressive disorder (MDD). However, research on LSD microdosing in clinical populations remains limited. Objectives: This study aimed to understand the experiences of individuals participating in an open-label trial of LSD microdosing for MDD. Design: Open-label pilot trial in target population (MDD; phase IIa). Methods: Seventeen participants with MDD completed an 8-week LSD microdosing regimen, dosing twice weekly. Following the intervention, participants underwent semi-structured interviews regarding their experiences. Data were analysed using thematic analysis. Results: Themes were grouped into five categories: enhanced self-determination, increased connectedness, improved cognitive processing, better emotional well-being, and negative effects. Conclusion: Reported effects appeared to reinforce one another; that is, self-determination led to feeling more connected, which enhanced cognitive processing and ultimately improved emotional well-being and reduced depressive symptoms. However, this effect was not universal; some individuals reported negative effects or no significant improvement from microdosing LSD. This variability may be due to individual differences in response, insufficient dosage, or the treatment’s lack of effectiveness for some individuals. The presence of side effects highlights the need for a careful titration protocol, while the lack of symptom improvement in some cases reinforces that microdosing is not a guaranteed solution, and expectations should remain realistic. The absence of a placebo control represents a key limitation as it precludes attribution of observed changes specifically to LSD. Trial registration: ANZCTR, ACTRN12623000486628. Registered on 12 May 2023 ( https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385758 ).

BACKGROUND:The pathophysiology of neuroinflammation in psychiatric conditions remains poorly understood, highlighting the need for noninvasive tools that can measure neuroinflammation in vivo. We explored advanced diffusion-weighted magnetic resonance imaging (MRI) techniques for detection of low-level neuroinflammation induced by typhoid vaccine, with potential applications to psychiatric disorders. METHODS:Twenty healthy volunteers (10 males; median age 34, range 18-44 years) participated in a randomized, placebo-controlled, crossover design study. Participants underwent MRI before and after receiving placebo or vaccine in alternating sessions, separated by a washout period. Diffusion tensor (multishell and single shell), diffusion kurtosis, and neurite orientation dispersion and density imaging parameter maps were generated. Probabilistic tractography investigated differences in tract volume, fractional anisotropy, and mean diffusivity (MD) of the tracts. Thirteen tracts and 15 regions were analyzed using a region-of-interest (ROI) approach entered into linear mixed models to evaluate treatment effects. RESULTS:A treatment effect was observed on white matter tracts derived from XTRACT, with a global reduction in MD (p = .040). White matter tracts of interest showed increased axial kurtosis (p < .001) while gray matter ROIs demonstrated increased mean and radial kurtosis (both ps = .038). Additionally, several correlations were found between the inflammatory marker interleukin 6 and diffusion parameters. CONCLUSIONS:Our findings demonstrate that diffusion-weighted MRI may be sensitive to inflammation-induced microstructural changes in the brain. Future studies should integrate complementary techniques and clinical assessments to deepen our understanding of inflammatory pathophysiology and its implications for health outcomes in clinical populations.

Mental health is essential for overall wellbeing, enabling individuals to cope with daily challenges and participate fully in society. Globally, nearly one billion people are affected by mental health conditions, including rising rates of depression, anxiety, autism, and dementia. In countries like Aotearoa New Zealand, approximately 26% of the population experiences poor mental wellbeing. However, traditional approaches to diagnosis and treatment often fall short due to limited resources and access to care, prompting a shift toward digital health solutions. This editorial explores how big data and artificial intelligence (AI) are transforming mental health research and care. These technologies offer new possibilities for early detection, scalable interventions, and personalised support addressing gaps in existing systems. We highlight key use cases across depression, autism, and dementia, where AI-driven tools are already showing promise in screening and supporting decision-making. We also examine AI applications in detecting depression, autism, and dementia, and the role of chatbot-based tools. The editorial also explores key challenges such as ethical concerns, data bias, and integration into healthcare systems, highlighting the need for responsible and inclusive AI development.