Abstract

Background
Depression results from interactions between biological, social, and psychological factors. Literature shows that depression is associated with abnormal brain structure, and that socioeconomic status (SES) is associated with depression and brain structure. However, limited research considers the interaction between each of these factors.
Methods
Multivariate regression analysis was conducted using UK Biobank data on 39,995 participants to examine the relationship between depression and brain volume in 23 cortical regions for the whole sample and then separated by sex. It then examined whether SES affected this relationship.
Results
Eight out of 23 brain areas had significant negative associations with depression in the whole population. However, these relationships were abolished in seven areas when SES was included in the analysis. For females, three regions had significant negative associations with depression when SES was not included, but only one when it was. For males, lower volume in six regions was significantly associated with higher depression without SES, but this relationship was abolished in four regions when SES was included. The precentral gyrus was robustly associated with depression across all analyses.
Limitations
Participants with conditions that could affect the brain were not excluded. UK Biobank is not representative of the general population which may limit generalisability. SES was made up of education and income which were not considered separately.
Conclusions
SES affects the relationship between depression and cortical brain volume. Health practitioners and researchers should consider this when working with imaging data in these populations.

Introduction

Mental health problems are significant public health issues within the UK and worldwide, with depression being one of the most prevalent. Research shows that there is a relationship between depression and brain structure (Tang et al., 2007; Kronmüller et al., 2009; Bos et al., 2018; Maggioni et al., 2019), and that social factors, including socioeconomic status (SES), are associated with both depression (Delgadillo et al., 2016; Marmot, 2010; Freeman et al., 2016) and changes in brain structure (Kweon et al., 2022; Colich et al., 2020; Jednoróg et al., 2012; Noble et al., 2015). However, these three factors are rarely all considered together. Given the impact of depression on both the individual and society, as discussed below, understanding the mechanisms of this disorder, to improve prevention and treatment options, is of critical importance.

Around 1 in 6 adults in England met the criteria for a common mental health disorder in the week prior to being surveyed (McManus et al., 2016). Mental health problems are one of the leading contributors to overall worldwide disease burden and are reported to account for 16 % of Disability Adjusted Life Years (DALYs, Arias et al., 2022). They confer substantial societal and economic implications with an estimated annual cost in England of £77 billion (Kirkwood et al., 2010). Depression is one of the most prevalent mental health problems, affecting approximately 5 % of adults (World Health Organization, WHO, 2023) and 280 million people globally (Institute of Health Metrics and Evaluation, 2023). Depression can be long-lasting with a single chronic episode, or recurrent, with many episodes over a long time, and has a substantial impact on an individual’s ability to function and cope with daily life. The risk of suicide is reported to be about 15 times higher in those with depression than the general population (Cipriani et al., 2005). This is however likely to be an underestimate as many who die by suicide have undiagnosed depressive symptoms.

Conclusion

This study is, to our knowledge, the first study to examine the relationship between depression, cortical volume, and SES in a middle-aged to older sample of this size. Given that SES appears to impact the relationship between depression and brain structure, we posit that SES should be a consideration for clinicians and scientists working with imaging data in these populations. Future research involving large-scale longitudinal data is needed to elucidate the causal relationships between the factors examined in this study.

Abstract

     Becoming a parent is a challenging transition, and stress factors may arise. This scoping review aims to map, from the literature, the structure, potential barriers, and facilitators to be considered when conducting a parenting programme for parents of children up to 3 years old. It followed the JBI methodology and included studies with parents of children up to 3 years old (Participants), studies about parenting programme structure, its potential barriers, and facilitators (Concept) in the healthcare or community setting (Context). Qualitative and/or quantitative study designs and grey literature publications between 2016 and 2021 were eligible. The search was performed in three stages in CINAHL Plus with Full Text, MEDLINE with Full Text, and PubMed databases. It was also conducted in OpenGrey, ProQuest, Portuguese Open Access Scientific Repository, and Google Scholar. Fourteen articles were selected. The following aspects were identified regarding parenting programmes: benefits; structuring elements to be considered; facilitating factors and possible barriers to its development, and measurement instruments to assess the programme. Parenting programmes are important ways to contribute to a healthy, sustainable, and resilient society. It should be adapted to individuals, groups, and communities. They add value to parents, children, and society and should be carefully adapted to the group’s needs.

Introduction

     Healthy development during childhood promotes vigorous adulthood, contributing to a productive and sustainable society. A family household is where children establish first relationships, attachment, and continuous interaction, learn to trust and become acquainted with basic social rules [1]. However, it is also where most child abuse occurs, often caused by a parent [2–6]. This toxic stress impact on the early years triggers adverse adulthood outcomes and shortens life expectancy [7–10].

     Different kinds of stress can be induced: positive, tolerable, and toxic. The first is a normal part of healthy functioning; the second is more intense and long-lasting but can be buffered by supportive relations allowing the nervous system to get back on track; toxic stress arises from prolonged adverse childhood experiences (ACEs) such as reiterated abuse, chronic neglect, exposure to violence, or accumulated economic hardship in the family [8].

     Parents and family are those closest to the child and are expected to be the best caregivers [11]. However, cumulative toxic stress can occur without appropriate parental support, which may cause development disruption [12] and promote morbidity before adulthood and early death [8,12].

Conclusions

     This study provides an overview of parenting programmes, and the results guide several recommendations for the future. The results of this article may help public health professionals to plan evidencebased parenting programmes with better outcomes for families, children, and society. These results will guide professionals in constructing more sustainable and effective parental programmes.

      Considering the various benefits, such as increased parent competence, self-efficacy, lower parental stress, lower depression symptoms, and child behaviour problems, implementing parental programmes is an added value for parents, children, and society. However, professionals should be aware of the barriers identified in this study (related to distance strategies and individual needs) and carefully adapt any programme to individual, group or community needs.

     Parenting programmes are important ways to contribute to a healthy, sustainable, and resilient society. They benefit parents by reducing signs of stress and depression and increasing their self-efficacy and social behaviour, which leads to positive changes in childcare. In addition, they bring benefits to the parent–child relationship by relieving social pressure from parents, allowing a focus on the relationship with the child as an individual. Finally, parenting programmes also positively affect society through knowledge sharing, networking, and support so that children can grow up in healthy environments and maximise their full potential.

Abstract

Background
Perinatal depression is a significant concern affecting both women and men during pregnancy and postpartum periods. While maternal postpartum depression has been extensively studied, paternal depression remains under-researched despite its prevalence and impact on family well-being. This study aimed to estimate the trajectories of perinatal and postpartum depression in Japanese parents over ten years and to determine the details of the symptoms of postpartum depression for each trajectory group, considering reciprocal effects between maternal and paternal depression.

Methods
A total of 789 couples used the Edinburgh Postnatal Depression Scale to rate their depressive symptoms prenatally; at 5 weeks, 3 months, 6 months, and 1 year postpartum; and then yearly thereafter until the 10th year. Parallel-process latent class growth analysis was used to group participants according to their longitudinal patterns of depressive symptoms.

Results
For both mothers and fathers, four depressive symptom trajectories fit the data best and were most informative (escalating: 6.5 %; mothers low and fathers moderate: 17.2 %; mothers high and fathers low: 17.9 %; low: 58.4 %). A variance analysis showed significant class-parent interactions across anhedonia, anxiety, and depression subscales, indicating distinct patterns of depressive symptomatology.

Discussion
Tailored mental health programs and universal screening using the Edinburgh Postnatal Depression Scale are recommended to address the specific needs of each trajectory class. This study contributes to the understanding of long-term depressive symptom trajectories in parents and emphasizes the necessity of comprehensive support strategies to enhance family well-being and resilience.

Introduction

Perinatal depression is a significant concern that affects a considerable number of women during pregnancy and after childbirth, with prevalence rates ranging from 7 % to 20 % (Dadi et al., 2022). Similarly, postpartum depression was found to be prevalent in 14.3 % of Japanese women one month after childbirth (Tokumitsu et al., 2020a). However, both men and women are affected by postnatal depression. A meta-analysis of 74 studies with 41,480 participants found that paternal depression was present in 8 % of men in the included studies (Cameron et al., 2016). Approximately 10 % of Japanese men experience perinatal depression, highlighting that this condition is a concern for both sexes (Tokumitsu et al., 2020b). The mental health of both parents during the perinatal and postpartum periods is crucial, as it can significantly impact the overall well-being of children and families. A meta-analysis further revealed that 3.18 % of couples might experience perinatal depression simultaneously (Smythe et al., 2022). Longitudinal studies have also shown that depressive symptom trajectories can persist for up to 11 years postpartum (Mughal et al., 2023). Therefore, this study’s primary objective was to estimate the trajectories of perinatal and postpartum depression in Japanese parents and their associated risk factors, considering the reciprocal effects of postpartum depression on fathers and mothers.

Conclusion

This 10-year longitudinal study identified four distinct joint trajectories of mothers and fathers’ depressive symptoms from pregnancy to postpartum: low and stable for both parents, high for mothers and low for fathers, moderate for fathers and low for mothers, and escalating for both parents. The findings emphasize the importance of early detection and continuous monitoring of depressive symptoms, including anhedonia, anxiety, and depression, in both parents. Tailored mental health support programs are critical, especially for mothers in Class 2 and fathers in Class 4, who exhibit higher and prolonged symptoms. Despite limitations such as sample size reduction and external factors influencing results, the study adds to the growing body of knowledge on postpartum depression, underscoring the need for comprehensive and targeted approaches to support families and improve mental health outcomes through timely and appropriate interventions. Future research should include larger, more diverse populations to enhance generalizability and explore effective long-term intervention strategies.

Abstract

The ability model of emotional intelligence (EI) specifies that four related abilities are involved: perceiving emotions, facilitating thought using emotions, understanding emotions, and managing them. Several performance-based assessments have been developed to measure those four abilities. Although some researchers find empirical support for the four abilities, others have argued that emotional intelligence divides into three abilities, two or even a single, unitary ability (Legree et al., 2014; Palmer, Gignac, Manocha, & Stough, 2005). We reanalyzed archival data from four ability tests of emotional intelligence, Ns = 503, 5000, 1000, and 2000, conducting item-level exploratory factor models of all four assessments for the first time. Based on those analyses, we suggest possible revisions of the 4-factor model to guide future research and assessment.

Overview of the present studies

In our research here, we analyzed the four assessments, the MEIS, MSCEIT, MSCEIT YRV, and MSCEIT-2, all at the level of their individual items—allowing their items to form factors with one another freely and apart from the tasks to which they had been assigned. Our purpose was forward-looking and focused on the question, “If one were to take a fresh look, what would be the nature and number of abilities one might ‘see’ in existing tests?”

Conclusions and implications for assessment

Theory is a powerful tool in the sciences but it is also important to adjust theories as new empirical findings improve our understanding. The theory of emotional intelligence has been associated with two key ideas: That emotional intelligence can be assessed as a mental ability using intelligence tests, and further, that the intelligence divides into four more specific abilities: accuracy at perceiving emotion, facilitating thought, understanding feelings, and emotion management. Of the first claim—that EI is an intelligence and can be assessed with intelligence tests—there is little doubt: Research from the MEIS forward demonstrates that the four-area model of emotional intelligence can be operationalized as a series of ability-based assessments (MacCann et al., 2014).

The research here, however, indicates that the four-area model could benefit from some reconsideration. The findings indicate the robustness of scores reflecting Understanding and Managing abilities, but that the Emotion Perception area may be more multi-dimensional than the original theory indicated, and that a “Connecting Emotional Features” score may better represent certain tasks than the earlier-conceived “Facilitating Thought” area. The findings make room, as well, for as-of-yet unclassified tasks (see Fig. 1). Collectively, the results encourage us to rethink EI in ways that have plain implications for future measures.

To the degree such new understanding closer approximates the reality of mental abilities in this area, it can inform applied practice so that the consultant and the clinician can provide people with more accurate feedback as to their abilities. A better understanding, such as this research provides, can help ensure that test scores convey distinctive meanings that are better understood than before—a key contributor to meeting the standards of optimal assessment (Joint_Committee, 2014; Sinharay et al., 2011). It is our hope that the findings obtained here, along with further research in the area, will help promote a better understanding of the nature of the ability model of emotional intelligence and its application.

Abstract

Positive Psychology has reconstructed how we understand happiness. The practices and discourses it presents to perform that reconceptualization appear as if free from political interest or intentionality. However, this article will show that its proposals define a subtle new form of government which we will call Psychopolitics. Instead of placing the population or the body of the citizen at the centre of political struggles, it focuses on the psyche. Through an extreme defence of positive emotions and happiness as the key to a good life, Positive Psychology promotes a type of friendly power relations, which instead of punishing motivates and empowers the individual’s creativity. To illustrate all of this, we conducted a case study with a Positive Psychology training course taught in a Spanish state university. Content analysis was used to explain the recurring themes and practices of this new discipline of positivity, showing how health is redefined around the happiness axis, and how happiness becomes an individual responsibility. We conclude that all these dimensions are simply a categorical definition of a new type of power relations which may characterise the 21st century.

Introduction: Happiness and positive psychology

As several authors (Arguís et al., 2010; Diener & Seligman, 2002; Fordyce, 1977) have remarked, happiness is one of the major goals regarded as exceptionally valuable in the sociocultural imaginary of our contemporary societies. It is a commonplace in academic literature to state that this is a construct which varies both diachronically – that is, over history, and synchronically – through culture and political axes. If we go back to Classical Greece, we quickly find that it was considered a greater good (Aristotle, 2009). On the other hand, in the Middle Ages, happiness appears as something we obtain in the next life (Aquinas, 2010; Augustine of Hippo, 2019). If we look at its definition in other cultures, past and present, but characterised by their distance from our own cultural coordinates, we find that happiness is included with values centred in the body or in collective well-being. All these examples show that its definition varies and multiplies depending on temporal, local, social, religious, and political coordinates (see Table 3, Table 4, Table 5, Table 6, Table 7).

More recently, and in our immediate context, in the Modern Age, with the American Declaration of Independence (1776) and the French Declaration of the Rights of Man (1789), happiness was proclaimed to be a right. Along these lines, a plethora of movements have emerged in the Contemporary Age which approach this right and feeling from a more practical perspective, based on scientific principles (Lyubomirsky, 2008; Seligman, 2002; Seligman & Csikszentmihalyi, 2014). The most recent conception, considered to belong to the 21st century, suggests that happiness may not be governed only by rulings which control people’s lives through their bodies or their religious values, but also through the immediate and productive management of the psyche (Han, 2014; Stiegler, 2013). This notion should not be understood as a genetic, idiosyncratic and deep-rooted dimension of the individual which could be externalised through words or observation as it was in the 19th century, with the clearest examples being psychoanalysis or classic cognitive psychology, but more from an existential perspective of meaning in life, initially explored in the 20th century by the psychiatrist Viktor Frankl (1959), whose experience of being a prisoner in a Nazi concentration camp can be used to address today’s global psychological problem of suicidal behaviours (Costanza et al., 2020, Costanza et al., 2020) after the financial crisis (Economou et al., 2013) and the COVID-19 pandemic (Costanza et al., 2021). Nowadays, the psychic realm has received a new, much broader and more operational definition, which makes it a set of relationships between internal aspects of the human being (which pass through the body and cognition) and other external aspects which pass directly through knowledge and the technologies which have recently begun to dominate our everyday lives (apps focusing on health, mindfulness, balanced diets, etc.). This is the result, among other things, of the fact that although in recent years we have put much more emphasis on looking for the so-called society of wellbeing (Rose et al., 2006), which emphasises care for the somatic, at present being physically well is no longer enough, and we are required to go a step further. Thus, the transformation of different world organisations in relation to the concept of health is clear. While in 1948 the World Health Organization defined health as “a state of complete physical, mental and social wellbeing, and not the mere absence of disease or infirmity” (WHO, 1946), by the end of the 20th century it was considered “a positive concept emphasizing social and personal resources, as well as physical capacities” (PAHO, 1986). In this new accepted sense, “personal” covers everything which was formerly called mental, but many more axes too, such as our relationship with the information generated by certain healthcare apps, the results we get from psychological or intelligence tests, or our interpersonal skills. In this pivot by the WHO we see health become an assumption, and the new goal of every citizen becomes achieving absolute and overall or comprehensive positive well-being. At this crossover of dimensions is when the so-called “psyche” acquires a new definition and value.

Conclusions

Positive Psychology has reconstructed how we must understand happiness. Its practices and discourses have spread to every action of our everyday life. Although it is presented as a discipline taking no part in the main mechanisms of power, we have found that it subtly reproduces a new modality of power and control, called Psychopolitics. Here, the arena of political struggle and conflict have moved from the notion of the bios to that of the psyche. This is what enables us to define a productive, active individual aligned with the requirements of the status quo, the practical consequences of which are spreading into the spheres of our everyday reality through the creation of more happiness programs in the field of education, well-being workshops to manage one’s emotional health at work, new positive applications to the “citizen science”, and obviously training in the field of psychology as well, where life coaching has become so important that it is now the new definition of Popular Psychology.

However, Positive Psychology does something more than just reproduce a power mechanism; it creates it to maintain itself and it has established a variant or nuance of Psychopolitics which we have called the Psychopolitics of Well-being. Here and now, the good life, the life worth living, is the life that is constantly seeking the well-being generated by positive thoughts and emotions.

Abstract

The current paper aimed to analyze quantitatively the trends of four major schools of thought in scientific Psychology (neuroscience, cognitivism, behaviorism, psychoanalysis) and their intersections, covering the period from 1979 to 2020. We utilized a rigorous methodology across three distinct sources: Mainstream Psychology (MP), Highly Influential Journal (HIJ), and non-English papers (NEP). Our findings align with previous research in two aspects: psychoanalysis and behaviorism have significantly declined, cognitivism remains a prominent trend. However, we deviate from prior studies by recognizing that neuroscience may be considered the most influential trend and that trends exhibit less linearity than previously assumed. We also acknowledge the significance of NEP, which manifest an independent pattern as compared to the other sources and that may reveal what happens in the “periphery” of Psychology. It is noteworthy that NEP demonstrated a still lively contribution from psychoanalysis. Our study also highlights the insularity and lack of cross-fertilization among psychological subdisciplines, despite the widespread claims to the contrary. It eventually supports the inference that scientific Psychology is a non-paradigmatic or pre-paradigmatic discipline, pointing out the dominance of applied psychology and confuting the notion of overarching “grand theories”.

History of the empirical analyses of trends in psychology

The study conducted by Friman et al. (1993) was one of the pioneering empirical investigations into the trends of subdisciplines within the field of Psychology. The authors specifically focused on psychoanalysis, behaviorism, and cognitivism during the years 1979–1988, utilizing data obtained from the Social Science Journal of Citation Reports (SSJCR). In their research, the authors selected four influential journals that represented each subdiscipline, taking into consideration various criteria, including a relatively high Impact Factor (IF)1 (for further details see Friman et al., 1993, pp. 659-660). For instance, Cognitive Psychology, Cognition, Journal of Experimental Psychology: Learning, Memory, and Cognition, and Memory & Cognition, aligned with the cognitive approach.

In the study conducted by Friman et al. (1993), the four selected journals representing each sub-discipline were examined using four different indexes: IF, Immediacy Index (II),2 citation number (the number of times the journal has been cited during a given year), and source items (the number of citable items the journal has produced during a given year). These indexes were calculated for each journal on an annual basis, and then averaged across the four journals to obtain single indexes for each sub-discipline. The three indexes were eventually plotted against each other. The main finding of the study indicated a significant increase in prominence for the cognitive school of thought. However, it was observed that the citation numbers and source items for behaviorism and psychoanalysis, although lower than those of cognitivism, were not substantially inferior. Despite the rise of the cognitive school, the study did not provide evidence for a clear-cut Kuhnian paradigmatic shift. Additionally, when considering the broader context of the social sciences, all three sub-disciplines (cognitive, behaviorism, and psychoanalysis) performed relatively well in comparison to other indexed journals in the SSJCR.

Conclusion

Taking a more speculative and substantial perspective on the history of Psychology, it can be inferred from the current data that over the past 40 years, the major scientific discourses have predominantly centered around the brain. Many recent studies (Bittermann & Fischer, 2018; Tracy et al., 2004; Yeung, Goto, & Leung, 2017; Wieczorek et al., 2021) suggest an increasing importance in neuroscience within Psychology and more widely across all natural sciences, and Benjafield (2020) highlights how the vocabulary of Psychology is more dependent on Biology than vice versa. These observations suggest an imbalance favoring biologically-based theories over emergentist/spiritualistic ones, although it does not necessarily imply a complete endorsement of materialism by neuroscientists. Rather, it might signify only an informal inclination towards biologically-based explanations. It is noteworthy that psychological researchers rarely adopt a clear ontological standpoint on “mind” and “behavior” and generally avoid extensive engagement with philosophical and theoretical issues (Henriques, 2011; Zagaria et al., 2020).

All things considered, the enduring and relatively stable patterns observed over a 40-year period are indicative of the robustness and vitality of Psychology as a discipline. These patterns demonstrate that the theoretical assumptions regarding the mind have exhibited relative stability over an extended duration.

Abstract

Suicide is a major public health problem worldwide with far-reaching effects on families, communities, and societies. Influencing factors range from macro-level interventions like alcohol control policies and suicide prevention programs to individual contributors such as alcohol abuse and domestic violence. This study aimed to examine the relationship between Chile’s suicide rate changes from 2002 to 2015 and the Alcohol Act of 2004, a national suicide prevention program implemented in 2007, alcohol abuse, and domestic violence. Assembling a unique longitudinal dataset from Chilean public institutions, the study employed an instrumental variable time-series cross-regional design. Results indicated that the Alcohol Act was not associated with suicide rates, domestic violence exhibited a significant association with increased suicide rates, and the national suicide prevention program was linked to reductions in suicide rates, especially among males. These findings align with research from neighbouring countries, showcasing the efficacy of suicide prevention programs in decreasing suicide rates in Chile. Results highlight the importance of integrating protocols to early-detect domestic violence in suicide prevention programs, as well as the need to further improving alcohol control policies to complement suicide prevention programs.

Introduction

Suicide is a major public health problem worldwide with effects on families, communities, and society. Globally, there are 703,000 annual deaths by suicide (World Health Organization, 2021). The global age-standardized suicide rate in males (12.6 per 100,000) is more than double that in females (5.4 per 100,000) (World Health Organization, 2021). Suicide prevention is a priority for the WHO and is included as an indicator in the United Nations Sustainable Development Goals (World Health Organization, 2021).

Alcohol use is a substantive risk factor for both deaths by suicide and suicide attempts (Amiri and Behnezhad, 2020; Isaacs et al., 2022; Perez et al., 2022). Furthermore, acute high-dose alcohol use increases the risk of suicide (Borges et al., 2017; Conner and Bagge, 2019; Razvodovsky, 2009) and contributes to the adoption of more violent suicide means (Choi et al., 2018; Yeskendir et al., 2022). Studies have consistently found that alcohol abuse and intoxication are prevalent in suicidal behavior (Norström and Rossow, 2016). Hence, strategies to control alcohol abuse and intoxication could impact suicides attributable to alcohol use (Anderson et al., 2009; Babor et al., 2010; Ilhan and Yapar, 2020).

Conclusion

The reduction in suicide mortality following the implementation of Chile’s Suicide Prevention Program leads us to the conclusion that, despite using a crude operationalization, this policy incorporates changes that help anticipate triggers of suicidal behavior in targeted populations. Future research as well improvements in Chile’s Suicide Prevention Program should aim to better understand the mechanisms linking alcohol abuse, domestic violence, and suicide. From a research perspective, better relevant variables, including policy implementation and design, and other measurements of alcohol abuse and domestic violence should be explored further. From a suicide prevention policy perspective, it is advisable to consider a more explicit integration of at-risk groups, such as victims of domestic violence and/or individuals with alcohol related risks, into the early warning systems of Chile’s Suicide Prevention Program.

Abstract

Background
A range of factors including mental disorders, adverse events and history of self-harm are associated with suicide risk. Further examination is needed of the characteristics of suicides which occur without established risk factors, using national surveillance systems.

Methods
Data on all suicides in Ireland from 2015 to 2017 were drawn from the Irish Probable Suicide Deaths Study (IPSDS). Variables examined included socio-demographics, psychiatric history and precipitant stressors. Suicide data were linked with data on prior self-harm from the National Self-Harm Registry Ireland (NSHRI). Latent Class Analysis (LCA) was used to identify sub-groups of suicide cases.

Results
Of the 1809 individuals who died by suicide, 401 (22.2 %) had a history of hospital-treated self-harm. Four distinct profiles of suicides were identified. One group was marked by high levels of prior self-harm and mental health conditions. Two of the groups included few individuals with a history of self-harm but had notably high levels of mental health conditions. These two groups had relatively high levels of reported chronic pain or illness but differed in terms of socio-demographics. The final group, predominantly male, had markedly low levels of mental health conditions or self-harm but high levels of personal stressors and substance use.

Limitations
The use of coronial data may be limited by bias in the collecting of information from the deceased’s family members.

Conclusions
A sub-group of suicide cases exists without any psychiatric or self-harm history but with salient occupational or health-related proximal stressors. Suicide prevention interventions should include occupational settings and should promote mental health literacy.

Introduction

Suicide is a major global health concern, with over 700,000 people around the world dying by suicide every year (WHO, 2021). The causes of suicide are complex, encompassing individual factors such as genetic influences and mental disorders, contextual factors such as family influences, history of abuse, socioeconomic conditions, exposure to suicidal behaviour by others, access to means for a suicidal act and lack of support in a crisis (Hawton and Pirkis, 2017). Self-harm is associated with a significant risk of subsequent death through suicide (Hawton et al., 2015; Vuagnat et al., 2019). Risk of suicide among individuals in the year after a suicide attempt has been estimated to be up to 100 times higher than matched community controls (Tidemalm et al., 2015), while a meta-analysis of psychological autopsy studies reported that self-harm history was associated with a ten-fold increase in suicide risk (Favril et al., 2022). A recent national Irish study reported one-year risk of suicide following an episode of hospital-treated self-harm to be 0.8 % (Griffin et al., 2023).

Conclusion

The majority of suicides occurred in individuals with no prior history of hospital-treated self-harm. Those who had previously presented to hospital had higher levels of known risk factors from socio-demographic and psychiatric domains. Among males in particular, a sub-group was identified without any psychiatric history and low levels of known risk factors, but with salient occupational or health-related proximal stressors. Suicide prevention interventions should include occupational settings as well as promoting support for those with chronic physical health conditions.

While mental illness remains a major risk factor, these findings suggest that emphasis needs to be placed on the broader psychosocial issues which may influence the pathway to suicide. In addition, it may be that the relative contribution of mental health conditions and other factors is fluid in relation to both life stage and life circumstances.

Abstract

Background. Psychological distress is a progressive health problem that has been linked to decreased quality of life among university students. This meta-analysis reviews existing randomized controlled trials (RCTs) that have examined the effects of mindfulness-based stress reduction (MBSR) on the relief of psychosomatic stress-related outcomes and quality of life among university students. Methods. The PubMed, EMBASE, Web of Science, PsycINFO (formerly PsychLit), Ovid MEDLINE, ERIC, Scopus, Google Scholar, ProQuest, and Cochrane Library databases were searched in November 2023 to identify the RCTs for analysis. Data on pathology (anxiety, depression, and perceived stress), physical capacity (sleep quality and physical health), and well-being (mindfulness, self-kindness, social function, and subjective well-being) were analyzed. Results. Of the 276 articles retrieved, 29 met the inclusion criteria. Compared with control therapies, the pooled results suggested that MBSR had significant effects, reducing anxiety (SMD = −0.29; 95% CI: −0.49 to −0.09), depression (SMD = −0.32; 95% CI: −0.62 to −0.02), and perceived stress (SMD = −0.41; 95% CI: −0.60 to −0.29) and improving mindfulness (SMD = 0.34; 95% CI: 0.08 to 0.59), self-kindness (SMD = 0.57; 95% CI: 0.30 to 1.12), and physical health (SMD = −0.59; 95% CI: −1.14 to −0.04). No significant differences were observed in sleep quality (SMD = −0.20; 95% CI: −0.06 to 0.20), social function (SMD = −0.71; 95% CI: −2.40 to 0.97), or subjective well-being (SMD = 0.07; 95% CI: −0.18 to 0.32). The quality of the evidence regarding sleep quality and physical health outcomes was low. Conclusions. MBSR therapy appears to be potentially useful in relieving functional emotional disorders. However, additional evidence-based large-sample trials are required to definitively determine the forms of mindfulness-based therapy that may be effective in this context and ensure that the benefits obtained are ongoing. Future studies should investigate more personalized approaches involving interventions that are tailored to various barriers and students’ clinical characteristics. To optimize the effects of such interventions, they should be developed and evaluated using various designs such as the multiphase optimization strategy, which allows for the identification and tailoring of the most valuable intervention components.

Introduction

Mindfulness therapy is a standardized psychological intervention that aims to reduce stress, encourage mindful thinking habits, and allow recipients to manage difficult emotional processing. It focuses on the concentration of one’s attention in the moment, nonsubjective judgment, and openness to accepting personal experience and involves corresponding behavioral training, such as attention training, body scanning, and sitting meditation [1]. Previous research on psychological interventions has found that mindfulness therapy can help reduce stress among university students and affects their overall quality of life and the psychological functions to which they adapt [2].

The theoretical support and the understanding of the operating mode are reasonable but still have differences. Thus, the mental health benefits, potential effects, and limitations of mindfulness therapy for university students warrant further examination. Although education and social support can be effective in preventing and treating the underlying psychological problems among university students with poor mental health, such interventions do not always affect or improve psychological well-being [3, 4].

The most prevalent psychological symptoms among university students are anxiety, mental stress, and emotional distress, which can result in decreased functioning in the context of academic and interpersonal stress. Global mental health surveys conducted by the World Health Organization (WHO) indicate that mental disorders are highly prevalent among university students, with 12-month prevalence rates ranging from 20.3% to 45% of university students over the age of 18 [5–7]. The prevalence rates of insomnia, depressive symptoms, and anxiety symptoms were 37.80%, 48.20%, and 36.70%, respectively, among Chinese university students during the COVID-19 pandemic [8]. In a randomized controlled trial with 11,169 university students conducted by the WHO, students had increasing intentions to use mental health services: The results indicated lifetime use rates of 12.6% and 7.3% for psychotherapy and medication for emotional problems, respectively. Suicidal thoughts and behaviors and nonsuicidal self-injury within the preceding 12 months were also common, with 21.1% of students in the sample reporting suicidal ideation, 10.6% reporting suicide plans, 0.4% reporting suicide attempts, and 6.8% reporting nonsuicidal self-injury [5]. Furthermore, one previous study found that high-compliance mental health services had a significant effect on students’ intention to seek mental health services in the next semester [9–11].

Results

3.1. Description of Studies
A total of 276 studies items were initially obtained through the database search. Using NoteExpress, 193 deduplicated studies were obtained, and the remaining 220 items were obtained. After reviewing their titles and abstracts, 135 studies that were of incompatible research types were excluded. A total of 13 articles were further excluded after reading the full text, and the remaining 29 studies [24–53] were retained for data extraction. The baselines of the trials were comparable. The literature search process and results are shown in Figure 1.

Abstract

Research on burnout has garnered considerable attention since its inception. However, the ongoing debate persists regarding the conceptual model of burnout and its relationship with depression. Thus, we conducted a network analysis to determine the dimensional structure of burnout and the burnout-depression overlap. The Maslach Burnout Inventory-Student Survey and Patient Health Questionnaire-9 were used to measure burnout and depression among 1096 college students. We constructed networks for burnout, depression, and a burnout-depression co-occurrence network. The results showed that cynicism symptom was the most central to the burnout network. In the co-occurrence network, depressive symptoms (“anhedonia”, “fatigue”) and burnout symptom (“doubting the significance of studies”) were the most significant in causing burnout-depression comorbidity. Community detection revealed three communities within burnout symptoms, aligning closely with their three dimensions identified through factor analysis. Additionally, there was no overlap between burnout and depression. In conclusion, our findings support a multidimensional structure of burnout, affirming it as a distinct concept separate from depression. Cynicism, rather than exhaustion, plays the most important role in burnout and the burnout-depression comorbidity.

Introduction

Burnout has long been recognized as an occupational hazard in various human service occupations (Lacy and Chan, 2018; Maslach and Leiter, 2016; Sullivan et al., 2022; Weigl, 2022). Since its emergence, the concept of burnout has attracted increasing attention worldwide and has gradually expanded to include a more general range of occupations (Aronsson et al., 2017; Embriaco et al., 2007; Shanafelt et al., 2019). Burnout is now defined as a psychological syndrome, caused by prolonged occupational stressors. Additionally, personality traits, particularly neuroticism, play an important role in the development of burnout (Angelini, 2023). People with high levels of neuroticism may adopt maladaptive coping strategies that magnify the impact of adverse events in the workplace, leading to greater anxiety and exhaustion from work. In summary, both external and internal factors influence the development of burnout.

The widely accepted conceptual model of burnout is a multidimensional model that stratifies burnout into three dimensions: exhaustion, cynicism or depersonalization, and a lack of professional efficacy (Maslach and Leiter, 2016). However, in contrast to the increasing research on burnout, minimal advances have been achieved in the establishment of clinical diagnoses. An undetermined definition of burnout is reportedly the primary issue for a diagnostic consensus (Rotenstein et al., 2018). The evolving definitions of burnout contribute to variability in estimating its prevalence, posing challenges in policy development. Initially, exhaustion was identified as the most central and obvious manifestation of burnout (Maslach et al., 2001). Accordingly, in a few northern European countries, the diagnosis of burnout has been simplified to exhaustion; consequently, the focus of the public and policy has been limited to exhaustion alone. Meanwhile, some argued that despite the importance of exhaustion, it was not the most central component of burnout (Maslach and Leiter, 2008) and that focusing on exhaustion devalued the significance of burnout as a distinct construct. A recent study on the relationship between the three dimensions of burnout suggested that exhaustion is not the most closely associated dimension (Wu et al., 2021). Measurements using an alternative burnout structure exhibit better validity (Shoman et al., 2021). To date, there has been minimal consensus on the definition or dimensional structure of burnout, as well as the most important symptoms of burnout (Tavella et al., 2021).

Conclusion

The current study was designed to determine the structure of burnout and the burnout-depression overlap among college students at the network level. It specifically identified cynicism symptoms as crucial factors for burnout and burnout-depression comorbidity. Additionally, community detection analysis suggested a multidimensional structure for burnout, emphasizing that burnout should be considered distinct from the concept of depression. This study provides insights into the structure of burnout from the perspective of network analysis, and delineates the overlap between burnout and depression.

Abstract

To provide an overview of treatments in the pipeline for adults with attention-deficit/hyperactivity disorder (ADHD), we searched https://clinicaltrials.gov/and and https://www.clinicaltrialsregister.eu/ from 01/01/2010–10/18/2023 for ongoing or completed phase 2 or 3 randomised controlled trials (RCTs), assessing pharmacological or non-pharmacological interventions for adults with ADHD with no current regulatory approval. We found 90 eligible RCTs. Of these, 24 (27 %) reported results with statistical analysis for primary efficacy endpoints. While several pharmacological and non-pharmacological interventions had evidence of superiority compared to the control condition from a single RCT, centanafadine (norepinephrine, dopamine, and serotonin re-uptake inhibitor) was the only treatment with evidence of efficacy on ADHD core symptoms (small effect size=0.28–0.40) replicated in at least one additional RCT, alongside reasonable tolerability. Overall, the body of ongoing RCTs in adults with ADHD is insufficient, without any intervention on the horizon to match the efficacy of stimulant treatment or atomoxetine and with better tolerability profile. Additional effective and well tolerated treatments for adults with ADHD require development and testing.

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is characterised by developmentally inappropriate and impairing inattention plus hyperactivity and/or impulsivity (Faraone et al., 2024). ADHD is the most common neurodevelopmental disorder, affecting around 5 % of school-aged children worldwide according to a re-analysis of the Global Burden of Disease (GBD) data (Cortese et al., 2023) and 8 %, with an uneven gender distribution of 10 % for males and 5 % for females, based on an umbrella review including five systematic reviews and meta-analyses (57 unique primary studies) (Ayano et al., 2023).

Impairing symptoms of ADHD persist into adulthood in up to 75 % of the cases (Sibley et al., 2016), with an estimated prevalence of ADHD in adults at around 2.5 % (Song et al., 2021). ADHD is often comorbid with other disorders, including mood, anxiety, and substance use disorders, or dysfunctions, such as emotional dysregulation and executive dysfunction (Faraone et al., 2021), as well as physical disorders, including obesity and asthma (Arrondo et al., 2022).

Treatment options proposed for ADHD include pharmacological – encompassing stimulant and non-stimulant medications – and non-pharmacological interventions (Cortese, 2020). In currently available guidelines, pharmacotherapy plays an important role in the management of ADHD in adults. For instance, the 2018 (updated in 2019) National Institute for Healthcare and Excellence (NICE) guidelines (National Institute For Health and Care Excellence (NICE), 2019) suggested that medication (stimulants as first line, followed by the non-stimulant atomoxetine) should be offered after environmental modifications (such as reducing noise or distractions) have been implemented but ADHD symptoms are still impairing. Current medications for ADHD in adults are efficacious, albeit with lower effect sizes compared to children, especially in relation to stimulants for which effects sizes have been found to be high in children and medium in adults (Cortese et al., 2018). However, there are concerns around the safety of currently available ADHD medications, including their possible cardiovascular effects (Cortese and Fava, 2024) and limited abuse potential – even though the risk-benefit profile in general favours the use of medications, as recently highlighted by the ADDUCE project, a naturalistic, longitudinal, controlled study in 27 European child and adolescent mental health centres (e.g., Buitelaar et al., 2022). Therefore, there is a need for additional efficacious and safer medications for adults with ADHD.

Results

3.1. Overview of included RCTs
We initially identified 115 potentially eligible RCTs (Table S1). However, 25 of the RCTs of pharmacological treatments tested medications already approved for adults with ADHD for core symptoms of ADHD (Table S2), which will not be discussed further in the present article. Of the remaining 90 RCTs, around 27 % (n = 24) reported results with statistical analysis for primary efficacy endpoints; in the rest (73 %, n = 66), results with statistical analysis of significance were not reported/available (ongoing trials: 38 %, completed trials: 38 %, unknown status: 14 %, terminated: 4 %, not yet recruiting: 6 %).

Completed RCTs with positive results on at least one primary outcome (n = 26) and those with negative results on every primary outcome (n = 8) are reported in Table 1 (pharmacological treatment) and Table 2 (non-pharmacological treatment). When available, Tables 1–2 report also data on tolerability, in terms of percentage of participants who dropped out due to adverse events or those who experienced adverse events defined as serious by the study authors, in line with the above-mentioned FDA classification.

Abstract

Schizophrenia (SCZ) and obsessive–compulsive disorder (OCD) typically have distinct diagnostic criteria and treatment approaches. SCZ is characterized by delusions, hallucinations, disorganized speech, and cognitive impairments, while OCD involves persistent, intrusive thoughts (obsessions) and repetitive behaviors (compulsions). The co-occurrence of these disorders increases clinical complexity and poses significant challenges for diagnosis and treatment. Epidemiological studies indicate a significant overlap, with prevalence rates of comorbid OCD in SCZ patients ranging from 12% to 25%, which is higher than in the general population. Etiological hypotheses suggest shared genetic, neurobiological, and environmental factors, with genetic studies identifying common loci and pathways, such as glutamatergic and dopaminergic systems. Neuroimaging studies reveal both overlapping and distinct neural abnormalities, indicating shared and unique neurobiological substrates. Environmental factors, like early life stressors and urbanicity, also contribute to the comorbidity. The overlapping clinical features of both disorders complicate diagnosis. Treatment approaches include combining SSRIs with antipsychotics and cognitive behavioral therapy (CBT). The complexity of SCZ and OCD comorbidity underscores the need for a dimensional, spectrum-based perspective on psychiatric disorders, alongside traditional categorical approaches, to improve diagnosis and treatment outcomes.

Introduction

Schizophrenia (SCZ) and obsessive–compulsive disorder (OCD) are both debilitating psychiatric conditions, each with distinct diagnostic criteria and treatment approaches. SCZ, as defined in the DSM-5 [1], is a chronic mental disorder characterized by a range of symptoms, including delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and cognitive impairments [2,3]. These symptoms must be present for a significant portion of time during a one-month period, with continuous signs of disturbance persisting for at least six months, significantly impacting various areas of functioning, such as work, interpersonal relations, and self-care [1]. SCZ’s influence on everyday life can be profound, often leading to significant disabilities and incomplete recovery for many individuals [4]. Those with relatively positive outcomes still contend with social isolation, the stigma associated with the disorder, and fewer opportunities to build close relationships. Unemployment rates are exceptionally high among those with SCZ [5,6]. Common issues, such as unhealthy diet, weight gain, smoking, and substance abuse, contribute to a decreased life expectancy, shortening it by about 13 to 15 years [5,6]. Moreover, the risk of suicide over a lifetime for individuals with SCZ is estimated to be between 5% and 10% [7].

OCD, on the other hand, involves persistent, intrusive thoughts (obsessions) and repetitive behaviors (compulsions) aimed at reducing the anxiety generated by these thoughts [8,9]. Obsessions are defined as recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted, causing marked anxiety or distress. Compulsions are defined as repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rigid rules and as being time-consuming or causing significant distress or impairment in important areas of functioning [1]. OCD profoundly affects daily life, causing significant distress and impairment. Individuals with OCD often devote excessive time to their obsessions and compulsions, disrupting work, education, and personal relationships [10]. The disorder severely limits social and occupational functioning, with studies indicating that up to 60% of those with OCD experience moderate to severe daily impairment [10,11]. The quality of life for these individuals is considerably lower than that of the general population, with high comorbidity rates for depression and anxiety [9,10]. Regarding mortality, OCD is linked to a heightened risk of suicide; the lifetime prevalence of suicidal thoughts among individuals with OCD ranges from 36% to 63%, and the risk of suicide attempts is between 10% and 27% [12].

Discussion

The literature shows various overlapping factors between SCZ and OCD. Both disorders are fundamental pathological entities in psychiatry, due to their prevalence and the burden they impose [11,15,16,17,18]. They share a complex etiological and pathophysiological component, comprising genetic, environmental, and neurostructural elements [23,38,54,82]. Our review highlights how some of these elements demonstrate the following commonalities: shared genetic factors, environmental circumstances that may underlie both disorders, and shared neurostructural alterations. It is important, therefore, to consider studies that demonstrate common etiological and clinical characteristics. For example, a recent study using integrated bioinformatic analysis has highlighted shared genetic and molecular mechanisms between SCZ and OCD [119].

Due to the shared features and differing elements between the two disorders, treatment remains challenging. The pharmacological profiles of treatments for SCZ and OCD differ significantly, with SGAs potentially inducing obsessive symptoms by antagonizing the 5HT2A receptor [90]. Hence, further studies are necessary to determine the best treatment for OCSs in patients with schizophrenia. Preliminary recommendations include combining an antipsychotic with an SSRI, such as escitalopram [95].

Summary

The public health approach to suicide prevention requires us to move away from thinking about suicide as a purely clinical problem and to pay heed to the array of social determinants (such as financial hardship or domestic violence and abuse) that might lead people to consider suicide as an option. Clinical factors are important, and, indeed, clinical or indicated interventions are entirely appropriate for people who have reached a point of crisis and should be a mainstay of national suicide prevention strategies. However, our Series stresses the need for selective and universal interventions that tackle the pervasive problem of suicide in a more upstream way, preventing people reaching a crisis point. Many social determinants can best be addressed by sectors outside health, so we are calling for a whole-of-government commitment to suicide prevention. We make recommendations for actions in the areas of policy, practice, research, and advocacy. People with lived experience of suicide should have genuine involvement in all of these actions.

Introduction

The Comprehensive Mental Health Action Plan, initially released by WHO in 2013 and updated in 2021, sets a target of a 30% reduction in the suicide rate internationally by 2030.1 Figure 1 indicates how the annual figures are tracking against that target.2 In 2013, the age-adjusted global suicide rate was 10·0 per 100 000 population, and by 2019, the year for which the most recent international data are available, the figure was 9·0 per 100 000 (a 10% decrease), which seems promising. However, the trend line suggests that the reduction might be levelling off. In addition, the aggregate figures mask between-country and between-region inequalities. Low-income and-middle-income countries (LMICs), which account for 77% of the world’s suicides,3 have not fared as well as high-income countries (HICs) in reducing suicide, with factors such as access to means,4 poverty,5 alcohol use,6 and domestic violence and abuse7 being implicated. Suicide rates have also varied over time according to region, with a notable outlier being the Americas. The suicide rate in that region has not reduced, potentially due—at least in part—to a failure to address gun ownership in the USA.8 In this Series, we have argued that the only way we will make substantial inroads into the major problem of suicide is by reorienting suicide prevention activities through a public health approach.

Conclusion

Widespread adoption of a public health approach to suicide prevention is crucial for ensuring that the overall decreases in suicide rates that are being seen globally continue on a downward trajectory and occur across countries and regions. Suicide is a societal issue that requires a societal response; preventing suicide is everybody’s business. Garnering cross-sectoral commitment from all levels of government and meaningfully involving all stakeholders at every step on the journey will be transformative.