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Artificial intelligence and robotics are reshaping general surgery across the full perioperative continuum. This narrative review traces the history of surgical robotics from early teleoperated systems developed by NASA and the US Department of Defense to the current da Vinci Xi and SP platforms and examines how AI is now being applied at each phase of surgical care. In the preoperative setting, machine learning models outperform traditional risk scores in predicting postoperative complications, while deep learning applied to computed tomography (CT) and magnetic resonance imaging (MRI) improves tumor detection, lymph node staging, and surgical planning. Intraoperatively, AI-driven phase recognition systems achieve 85-95% accuracy in identifying procedural steps, computer vision tools assess the Critical View of Safety during laparoscopic cholecystectomy, and semi-autonomous robotic systems are beginning to reduce surgeon tremor and automate discrete operative tasks. In the postoperative period, AI-integrated wearable biosensors and electronic health record models enable earlier detection of complications such as sepsis and deep vein thrombosis, while personalized ERAS protocols are refined through continuous data streams. Despite these advances, significant challenges remain, including dataset bias, limited external validation, black-box model opacity, and unresolved questions around data privacy, liability, and regulatory oversight. AI currently functions as a decision-support tool rather than an autonomous actor. Broader clinical adoption will require larger multi-institutional datasets, improved model interpretability, and clear regulatory frameworks.

[This corrects the article DOI: 10.3389/fpsyt.2025.1611208.].

Bayesian models of cognition have gained considerable traction in computational neuroscience and psychiatry. Their scopes are now expected to expand rapidly to artificial intelligence, providing general inference frameworks to support embodied, adaptable, and energy-efficient autonomous agents. A central theory in this domain is predictive coding, which posits that learning and behaviour are driven by hierarchical probabilistic inferences about the causes of sensory inputs. Biological realism constrains these networks to rely on simple local computations in the form of precision-weighted predictions and prediction errors. This can make this framework highly efficient, but its implementation comes with unique challenges on the software development side. Embedding such models in standard neural network libraries often becomes limiting, as these libraries' compilation and differentiation backends can force a conceptual separation between optimization algorithms and the systems being optimized. This critically departs from other biological principles such as self-monitoring, self-organisation, cellular growth, and functional plasticity. In this paper, we introduce pyhgf: a Python package backed by JAX and Rust for creating, manipulating, and sampling dynamic networks for predictive coding. We improve over other frameworks by enclosing the network components as transparent, modular, and malleable variables in the message-passing steps. The resulting graphs can implement arbitrary algorithms as belief propagation. Moreover, the transparency of core variables can also translate into inference processes that leverage self-organisation principles and express structure learning, meta-learning, or causal discovery as the consequence of network structural adaptation to surprising inputs. The main functions of the library are differentiable and seamlessly integrate into sampling or optimization workflows. Additionally, we offer generalized Bayesian filtering and the hierarchical Gaussian filter as key examples of dynamic networks implemented in our library. The source code, tutorials, and documentation are hosted under the main repository at https://github.com/ComputationalPsychiatry/pyhgf.

Affective and psychotic disorders often emerge during adolescence and early adulthood. Early detection and timely treatment of individuals with mental disorders (particularly affective and psychotic disorders) can play a decisive role in improving the course of disease and treatment outcomes. To bridge the gap between early detection and evidence-based, integrated, and cross-setting treatment, there is a need for conceptual advancement and closer coordination of outpatient, day clinic, and inpatient care services, particularly during the transition between child and adolescent psychiatry and adult psychiatry. The aim of this paper is to present the services offered by the "Young People" track at the Carl Gustav Carus University Hospital in Dresden as a potential best-practice example. It addresses established workflows, team structure, and the nature and frequency of interventions. In addition, descriptive data on all individuals seeking help at the Early Detection and Intervention Center between May 2018 and October 2025 as well as those treated in the day clinic between December 2019 and December 2024 are analyzed. Care is provided through a stepped pathway-starting with an initial general, low-threshold point of contact, moving on to specialized early detection of affective and psychotic disorders, and culminating in targeted referrals to established outpatient, day-care, and inpatient treatment programs for young people. From May 2018 to October 2025, 859 young people made their first visit to the Early Detection and Intervention Center (52.5% female; average age: 24 years). 31.4% did not meet the criteria for a mental disorder, 35.4% fulfilled the criteria of one, 20.6% of two, and 12.6% of at least three diagnoses. N = 63 met the risk criteria for developing bipolar disorder, n = 77 for developing psychosis. More than 100 young people were treated in the outpatient setting. The day clinic treated N = 283 patients (average duration: 7 weeks) with high treatment acceptance and significant improvements in symptom burden, self-management, and quality of life. Initial steps towards establishing a specialized inpatient treatment programme are currently underway with the allocation of six beds for young people, enabling continuous care even in times of increased treatment needs. The services offered by the "Young People" track at Dresden University Hospital bridge potential gaps in care during the transition from adolescent to adult psychiatry. Through low-threshold early detection and risk-adapted, continuous, and cross-setting care, young people-with or without previous treatment experience-receive targeted support. Treatment tailored to their developmental needs facilitates inter alia processes of maturation, career orientation, and the gradual achievement of independence. The accompanying research ensures the continuous, evidence-based development of the integrative and patient-centered care concept, which, as a potential best-practice example in Germany, can represent a decisive step towards an effective and person-centered care system for young people with affective and psychotic disorders.

Linguistic abnormalities in schizophrenia (SCZ) span morphological, syntactic, semantic, and discourse levels. Converging cross-linguistic evidence suggests that SCZ may involve semantic narrowing alongside reduced syntactic differentiation, yet how these changes co-occur across linguistic domains and whether they represent core, task-general disturbances remains unclear. We applied a multilevel NLP framework to a large Japanese dataset to identify structurally related linguistic markers of SCZ across elicitation contexts. Speech from 104 patients with SCZ and 101 healthy controls was collected through semi-structured interviews. Transcripts from free conversation, storytelling, and picture description were analyzed using GiNZA, Word2Vec, TF-IDF, and SentenceBERT to extract 76 morphosyntactic, semantic, and discourse features. Factor analysis identified representative features independent of diagnosis, which were tested using generalized estimating equations and validated with bootstrap and permutation procedures. Cross-task stability was examined to determine core linguistic markers. In free conversation, reduced Case-particle (Kakujoshi) and Adverb use and increased Mean Pairwise Word Similarity were strongly associated with SCZ (AUC = 0.87, 95% CI: 0.74-0.97). Adverbial, case-particle, and semantic-network measures functioned as cross-task markers. SCZ involves multidimensional language disturbances characterized by a tripartite linguistic phenotype of diminished morphosyntactic explicitness, semantic narrowing, and reduced modification-based contextual modulation in spontaneous discourse. Extending cross-linguistic evidence, our results indicate that lexical-semantic contraction co-occurs with reduced overt marking of argument relations in Japanese, alongside weakened adverbial elaboration and framing - suggesting convergent, largely task-general dimensions of SCZ language pathology, most evident in free conversation.

Despite the growing global burden of mental health conditions, nationally representative data in low- and middle-income countries remain limited. Using data from the 2024 Uganda National Population and Housing Census, this study examined the prevalence and distribution of probable mental health conditions among persons aged 10 years and older in Uganda, while assessing variations by sex, place of residence and sub-region. We conducted a descriptive secondary analysis of publicly available census tabulations (2024 Volume I, Section 6.5). The analytic population comprised 31,389,721 individuals aged 10 years and older. Mental health outcomes were based on self-reported symptoms synthesised by the Uganda Bureau of Statistics into six indicators of probable mental health conditions, such as general psychological distress, depression, anxiety, bipolar disorder, psychosis and suicidality, rather than clinical diagnoses. Among persons aged 10 years and older, 3,773,915 (12.0%) reported probable general psychological distress. Probable depressive condition affected 2,444,272 (7.8%), followed by probable bipolar condition 1,262,088 (4.0%) and probable anxiety condition 1,201,182 (3.8%). Higher prevalence was observed among females and rural residents. Substantial sub-regional variation was observed across all outcomes, with the prevalence of general psychological distress ranging from ~8% in Madi, Sebei and Ankole to over 16% in Teso. The 2024 census suggests a substantial and uneven distribution of probable mental health conditions in Uganda and underscores the need for geographically targeted, equity-oriented mental health strategies, as well as stronger integration of mental health into primary healthcare systems.

Evidence suggests psychological factors including personality traits can have impact on the development and course of irritable bowel syndrome (IBS) and associated health-related quality of life (HrQoL), with large individual heterogeneity. Main aim of this study was to examine between-persons associations and within-sample concurrent associations of the personality traits neuroticism, extraversion, conscientiousness, openness and agreeableness with gastrointestinal (GI) symptoms, psychological factors and HrQoL in IBS-patients. Cross-sectional data from an observational IBS-study (n&#x2009;=&#x2009;194, mean age 51.36&#x2009;years, 74.4% female) was used. Patients completed the Big Five Inventory (BFI)-44 questionnaire regarding personality traits, and questionnaires on symptom severity (GSRS-IBS), general anxiety (HADS-A, GAD-7), GI-specific anxiety (VSI), and HrQoL (36-SF). A multivariable regression model and a network correlation analysis were performed. Neuroticism showed the most relevant between-persons associations, confirmed by within-sample concurrent associations: associated with increased GI-specific anxiety (B 7.234, p&#x2009;=&#x2009;0.040), general anxiety (B 0.954, p&#x2009;=&#x2009;0.040), and decreased mental HrQoL (B-3.576, p&#x2009;=&#x2009;0.007). Extraversion showed an opposing pattern including increased mental HrQoL (B&#x2009;=&#x2009;4.266, p&#x2009;=&#x2009;0.001), with strong association to neuroticism. While no significant between-person associations emerged between abdominal pain and personality traits, significantly associated to higher general anxiety (B&#x2009;=&#x2009;6.304, p&#x2009;<&#x2009;0.001) and GI-specific anxiety (B&#x2009;=&#x2009;0.034, p&#x2009;<&#x2009;0.001) were shown. This study reinforces the association between personality traits and IBS, highlighting the integral connection to not only other psychological factors but also GI-symptoms. These findings support a multifactorial, personalized approach to IBS, advocating for the integration of personality assessment-particularly neuroticism and extraversion-into the biopsychosocial model.

Individuals with schizophrenia (SZ) experience significantly greater obesity rates compared to the general population. The underlying biological mechanisms, however, remain poorly understood. Although brain functional connectivity (FC) has been associated with obesity in the general population, its role in obesity in SZ is largely unexplored. As such, this study examined FC contributions to adiposity in participants with SZ (n = 46) and an adiposity-matched comparison group without SZ (n = 46) as they completed resting-state functional magnetic resonance imaging in fasted and fed states. A machine learning approach identified FC patterns associated with adiposity (percent body fat), with model performance evaluated on an independent test set. In both fasted and fed states, brain regions involved in reward and eating behaviors contributed to adiposity prediction in both groups. While fasted, predictive connections in SZ largely involved limbic and sensorimotor networks, whereas comparison group networks were more varied. In the fed state, SZ predictive features included visual, default mode, and executive control networks, while comparison group connections involved limbic, sensorimotor, salience, and executive control networks. Findings may suggest shared, as well as diagnosis- and state-specific, FC patterns associated with adiposity in SZ, which may help inform future development of obesity-related interventions in this high-risk population.

The opinions of the autism community are crucial for the future of genetic research. This study examines the attitudes of autistic adolescents, adults, and parents of autistic individuals toward genetic research in Sweden. We aimed to determine respondents' views on genetic research in general and to understand their expectations and concerns. For this aim, we conducted two online surveys with closed-ended and open-ended questions - one aimed at parents of autistic children and another for autistic adolescents and adults. A total of 871 parents and 213 autistics participated. We show that the attitudes toward genetic research are generally positive, with both respondent groups hoping that it will lead to improved interventions, enhanced quality of life, better educational opportunities, and increased support services. The autistic group valued research studies that would provide individual results from genetic research. However, thematic analysis of the respondents' concerns on genetic research revealed that there are significant concerns about the potential misuse of genetic information, particularly regarding eugenics. Our results underscore the importance of engaging the autism community in genetic research to ensure its relevance and ethical integrity, ultimately facilitating the translation of research outcomes into tangible benefits for individuals with autism and their families.Lay AbstractThis study explored the attitudes of 871 parents of autistic children and 213 autistic adolescents and adults in Sweden toward genetic research. We aimed to understand whether they think genetic research in autism is positive and beneficial, what they hope the research will achieve, and if they have any concerns. Involving the autism community in Sweden is crucial for the future of genetic research in autism, ensuring it addresses their priorities and concerns. Overall, respondents had a positive view, hoping the findings could lead to better interventions, improved quality of life, enhanced educational opportunities, and stronger support services for autistic individuals and their families. However, many were worried about potential negative consequences, such as increased discrimination and the promotion of eugenics. These findings can guide researchers in designing future studies and highlight the importance of community involvement in research.

The Crisis Intervention Ward relocated from a general hospital to a psychiatric hospital in Basel, Switzerland, on May 26, 2023. We hypothesize that this relocation influenced patient demographics, frequencies of main diagnoses, involuntary admissions, transfer rates, clinical outcomes, patient satisfaction, and clinician perceptions of the treatment setting. We compared two patient cohorts: one from a 12 month period pre-relocation and the other from a 12 month period post-relocation. Two outpatient clinician surveys-one conducted pre- and one post-relocation-assessed location ratings, treatment satisfaction, and the perceived benefits and disadvantages of each location. Prior to relocation, 625 cases were treated; after relocation, 686 cases. Patient's age and gender showed no differences. The frequency of affective disorders (F3) was lower (&#x3a6; = - 0.124) at the psychiatric hospital. Clinical outcomes, involuntary patient admissions, and transfer rates to other psychiatric wards were comparable. Patient-reported satisfaction was lower at the psychiatric hospital (mean 4.6 vs. mean 5.2, r&#x2009;=&#x2009;0.23). Outpatient clinicians favored the general hospital setting strongly (r&#x2009;=&#x2009;0.78-0.81). Clinical outcomes remained stable, but patient satisfaction was lower after relocation, and clinicians perceived barriers related to accessibility and stigma at the psychiatric hospital.

Psychotherapy is a crucial treatment for various mental health conditions, with its effectiveness supported by substantial evidence. This study aimed to evaluate the attitudes of psychiatrists and psychiatric trainees in Thailand toward psychotherapy, including its utilization, training preferences, barriers to access, and views on digital resources, to help guide future psychiatric training and practice in the country. The 190-item ATPsySEA questionnaire evaluated attitudes toward psychotherapy across four domains: general attitudes, evidence-based utilization, barriers to access, and future training or digital perspectives. Participants were recruited through convenience sampling strategy via email and official chat channels. A total of 74 mental health professionals in Thailand completed the survey, comprising 67 psychiatrists and 7 psychiatric trainees. Data was analyzed using descriptive statistics. Respondents generally held positive attitudes toward psychotherapy. No prominent differences in attitudes were observed across demographic or clinical practice characteristics. A majority (63.5%) viewed being a psychotherapist as integral to their professional identity. While time constraints were acknowledged, most (75.6%) incorporated psychotherapy into their practice, often combined with pharmacotherapy (72.9%). Cognitive Behavioral Therapy (CBT), supportive psychotherapy, and mindfulness-based psychotherapy were the most frequently utilized. Barriers to access included time constraints (45.9%), systemic limitations (24.3%), and perceived lack of skill (9.5%). Respondents expressed a strong interest in further training, particularly in CBT and basic therapeutic skills. Thai psychiatrists and trainees hold positive attitudes towards psychotherapy, but face barriers to its implementation such as limited clinical time. Despite these insights, the results are subject to selection and social desirability biases inherent in the recruitment method and self-reporting format, necessitating a cautious interpretation of the data. NA.

General cognitive ability in childhood has been linked to differences in brain structure and connectivity in numerous studies. However, longitudinal examinations of links between early cognitive ability and multimodal brain development are limited. Leveraging longitudinal data from 10,495 participants of the Adolescent Brain Cognitive Development study, we examined whether childhood cognitive ability was associated with differences in longitudinal development of gray and white matter structure and resting state functional connectivity (rsFC). Linear mixed-effects models tested associations between baseline cognition-matrix reasoning, fluid cognition, crystallized cognition-and trajectories of whole-brain and regional brain measures. Brain measures included cortical thickness, surface area, and volume, fractional anisotropy, mean diffusivity, and rsFC across four time points. Across modalities, higher baseline cognitive scores were associated with slower increases in measures that normatively increased over adolescence and faster decreases for those that were found to decline. Specifically, higher childhood fluid cognition was associated with faster contraction of gray matter area and volume, and higher matrix reasoning was related to slower increases in white matter fractional anisotropy. Meanwhile, lower values in all cognitive measures-early matrix reasoning, fluid cognition, and crystallized cognition-were associated with greater increases in between-network rsFC that were absent in those with higher baseline cognitive scores. Regionally, differences in gray matter structural trajectories by cognitive ability were most prominent in the frontal lobe, while effects for white matter and rsFC trajectories varied across distributed brain systems. Findings provide insight into theories of cognition and highlight possible neurobiological pathways linking early cognition to long-term outcomes.

Among US teenagers, 79% of HIV infections are attributable to male-to-male sexual contact; yet, few interventions have been shown to effectively reduce sexual risk among gay and bisexual adolescents (GBA). Parent communication about sex is associated with adolescent sexual risk, and interventions to improve parent communication have been shown to successfully reduce sexual risk among heterosexual samples. However, no interventions designed specifically for parents of GBA have been tested in clinical trials. Parents and Adolescent Talking About Healthy Sexuality (PATHS) is a web-based intervention we created for parents of GBA that aims to improve parent communication about sexuality and HIV and increase parent behaviors supportive of GBA sexual health. This trial aims to test whether delivering PATHS to parents of GBA ages 14-19 years will improve GBA sexual health outcomes in the 6 months following intervention delivery. Secondary aims are to test whether the intervention's effects are sustained at 12 months after the intervention and to examine whether effects are mediated through specific parent behaviors. In total, 350 parents of GBA will be recruited online via social media advertising and randomized to receive either PATHS or an active control. PATHS is fully automated, self-paced, and can be completed in a single session lasting under an hour. The active control is an education entertainment film created to provide general support and guidance to parents of GBA. Both parents and their GBA sons will complete online assessments every 3 months over a 1-year period. Primary outcomes will be evaluated at 6 months after the intervention, and then, the control arm will crossover and receive PATHS, and dyads will be followed for another 6 months. Primary outcomes include both adolescent sexual preparedness (eg, condom skills) as well as HIV-related sexual risk behavior (ie, condomless anal or vaginal sex that is not protected by pre-exposure prophylaxis). The study was funded in March 2022, and we completed enrollment of 393 parent-GBA dyads in September 2025. We project that all participants will have completed study activities by November 2026, with data analysis and results of the trial forthcoming in the first quarter of 2027. If proven efficacious, PATHS will be among the first HIV prevention interventions shown to reduce sexual risk for GBA. Moreover, as other adolescent-focused interventions emerge, PATHS' unique focus on parents will offer a complementary, additional means for reaching GBA who do not engage with other intervention options. ClinicalTrials.gov NCT05852600; https://clinicaltrials.gov/study/NCT05852600. PRR1-10.2196/81316.

Studies that jointly examine the specific symptoms of problematic gaming and problematic social media use with comparable conceptualizations and link them to adolescent psychological well-being remain scarce. This study addresses this gap with an effective representative sample of n&#x2009;=&#x2009;33,586 adolescents aged 11-15 years across 10 European countries, collected in the 2021-22 Health Behaviour in School-aged Children (HBSC) survey. A network approach was applied to data about problematic media use (i.e., Internet Gaming Disorder Scale, Social Media Disorder Scale) and psychological well-being (i.e., WHO-5 Well-being Index, Multiple Health Complaints Scale, and Loneliness). In gaming and social media, either separately or together, escapism was both the most common and the key bridge symptom: it was connected to loneliness in both genders and to overall well-being and nervousness in girls. Behavioral symptoms that reflect negative consequences of use (i.e., conflict, deception, and problems with others) were strongly related across gaming and social media, suggesting that they reflect a general condition rather than a behavior linked to a specific media use. The findings highlight the central role of escapism in the interplay between adolescent problematic media use and psychological well-being, with some gender-specific differences. Symptom-level focus can guide prevention and intervention strategies. It can also prompt further research to move beyond aggregated symptom scores to better capture the heterogeneity of problematic media use as well as how specifically relevant the symptoms are for the two problematic behaviors in relation to psychological well-being.

Mind&#x2011;body practices, such as meditation and yoga, involve paying attention to breathing sensations. During these practices, individuals report "interoceptive lapses," moments when attention drifts away from internal bodily sensations. While lapses in attention to the external world have been widely studied, little is known about the physiological and neural mechanisms of interoceptive lapses. Interoceptive lapses may share markers with exteroceptive lapses-such as reaction time variability and default-mode network (DMN) connectivity-but may also depend on distinct brain systems and breathing physiology. We examined behavioral, physiological, and neural signals preceding lapses in a sample of 93 adolescents enriched for GAD and depression symptoms. Participants performed a 20-min breath counting task in the fMRI scanner with simultaneous breath recordings. Lapses were defined as moments when counting errors occurred. The sample was split into training and validation sets to test machine learning models predicting attentional lapses. The strongest predictors were timing and variability of button responses (AUCs > 0.75). Breathing variability and breathing-behavior synchronization showed smaller but generalizable predictive value (AUCs < 0.65). Whole-brain connectivity models also predicted lapses (AUC &#x2248; 0.65), incorporating the DMN, dorsal and ventral attention, and somatomotor networks. Furthermore, models that included brain connectivity marginally outperformed behavior-only models. Comparisons to previous exteroceptive findings indicate some common markers (e.g., reaction time variability) and some unique markers (e.g., selective perceptual coupling with attentional networks). Although limited by the clinical sample and lack of a control task, these results highlight brain-body markers of interoceptive attention that may inform real-time monitoring during mind-body interventions.

Inclusive health education content has been shown to increase acceptability and accessibility for lesbian, gay, bisexual, transgender, queer, intersex, and asexual, as well as other sexual and gender minority (LGBTQ+) individuals. However, there has been some backlash among general audiences, with claims that such inclusive content is "woke" or otherwise problematic. The goal of this study was to test whether individuals across the political spectrum notice when sexual and reproductive health content is written with inclusive language in order to demonstrate the acceptability of inclusive content to a broader audience. This study included 454 adults assigned female at birth from the United States, one-third of whom identified as LGBTQ+, reviewed 2 sets of reproductive health educational handouts designed for adolescents, with 1 gender-inclusive and 1 gender-specific version in each set, randomized in order. Individuals were asked to rate each document and state a preference within each pair (implicit preference). They were then debriefed on the study's purpose and asked if they had an explicit preference for gender-specific or gender-inclusive content. Preferences for explicit content tended toward gender-specific content: always gender-specific (n=184, 40.5%), sometimes gender-specific (n=59, 13%), no preference (n=131, 28.8%), sometimes gender-inclusive (n=39, 8.6%), and always gender-inclusive (n=41, 9%). However, most people (n=273, 59%) did not notice differences between the first pair of documents they viewed or rate them differently (mean difference -0.19, SD 2.17, range -10 to 12). Furthermore, the majority of individuals who had a stated preference for gender-specific health education documents did not choose the gender-specific document as their preferred version for either the first (n=45, 24%) or second pair of documents (n=69, 38%). Individuals who preferred content to always be gender-inclusive were significantly more likely to choose the concordant version of their document (n=20, 49% for the first pair; n=24, 58% for the second pair). A total of 58% (n=262) of the participants stated they did not notice the study design until the debrief. Most participants did not notice when sexual and reproductive health educational content had been made gender-inclusive-even when they had an explicit preference for gender-specific content. This suggests that when inclusive language is not directly called to readers' attention, inclusive sexual and reproductive health content is broadly acceptable to individuals across a range of political beliefs. The use of inclusive language may therefore be a means of increasing the accessibility and applicability of educational materials to diverse recipients, including LGBTQ+ individuals.

Older adults represent a high-risk group for suicide and are frequently exposed to central nervous system (CNS) drugs. Yet, the role of CNS drugs in late-life suicide remains unclear. We conducted a nationwide register-based matched case-control study (1:30) including all individuals aged 65&#xa0;years and older who died by suicide in Sweden between 2007 and 2020. Each case was matched to controls from the general population on age and sex, alive at the index date. Use of CNS medications was examined within 1-month, 3-month, and 12-month windows prior to the index date (date of suicide). Conditional logistic regression was used to estimate odds ratios (ORs) with adjustment for sociodemographic factors, number of other classes of medications (proxy for comorbidities), frailty score, self-harm history and major psychiatric diagnoses. Among 5971 older adults who died by suicide, 71.7% of cases used at least one type of CNS drug (vs. 35.2% of controls), while 34.7% of cases had dispensations for three or more CNS drug types (vs. 7.3% of controls) within one year before death by suicide. The most common drug classes among cases were hypnotics and sedatives (46.5%) and antidepressants (38.8%). About one third of cases used anxiolytics (32.3%) or minor analgesics and antipyretics (29.9%). Compared with controls, individuals who died by suicide more often used hypnotics and sedatives (adjusted OR 3.54, 95% CI 3.32-3.77), anxiolytics (aOR 3.27, 95% CI 3.04-3.52), antidepressants (aOR 2.50, 95% CI 2.33-2.68), and opioids (aOR 1.93, 95% CI 1.79-2.09) within 12&#xa0;months before suicide. Patterns were consistent across time windows. CNS medications are commonly dispensed before suicide in older adults, particularly hypnotics and sedatives, antidepressants, anxiolytics, and opioids. These findings describe medication use patterns preceding suicide and identify drug classes for further investigation.

This study aimed to examine the association between depression and adjustment disorder in a clinical sample of college freshmen, and to investigate the mediating roles of resilience and perceived social support in this relationship. A cross-sectional survey was conducted among 402 college freshmen enrolled in the Pediatric Psychology Department of Zhumadian Second People's Hospital. General data, the Patient Health Questionnaire (PHQ-9), Connor-Davidson Resilience Scale (CD-RISC), Perceived Social Support Scale (PSSS) and Adjustment Disorder-New Module 20 (ADNM-20) were completed by the participants. Descriptive, chi-square, and Pearson correlation analyses were conducted to characterize the sample and assess bivariate relationships, as appropriate for variable type. Hierarchical linear regression and path analysis were employed to examine the mediating roles of resilience and perceived social support between depression and adjustment disorder. &#x2460; Chi-square revealed no significant differences in adjustment disorder based on gender, age, only child status, childhood trauma experience, and educational level (P > 0.05). &#x2461; Pearson correlation analysis demonstrated significant relationships among the main study variables. Depression showed a strong positive correlation with adjustment disorder (r=0. 574, p<0.001), while both resilience (r=-0.653, p<0.001) and perceived social support (r=-0.550, p<0.001) were negatively correlated with adjustment disorder. &#x2462; Hierarchical linear regression analysis indicated that the level of depression positively predicted adjustment disorder (&#x3b2;=0.278, P<0.001), whereas resilience (&#x3b2;=-0.459, P<0.001) and perceived social support (&#x3b2;=-0.364, P<0.001)negatively predicted adjustment disorder among college freshmen. In a clinical sample of college freshmen, the impact of depression on adjustment disorder is partially mediated by resilience and perceived social support. Our results supported a model in which depression contributed to adjustment disorder both directly and by eroding personal resilience and perceptions of social support.

Individual differences in depression symptom severity are associated with negative self-relevant thoughts that can operate implicitly and increase vulnerability to major depressive disorder. However, most paradigms designed to probe such implicit processes rely on simplified stimuli and artificial self-relevant judgments. We asked whether neural activity measured during natural reading of clinically-grounded, self-relevant depression symptom probes can capture implicit, schema-based patterns of expectancy and evaluation grounded in individuals' depression-relevant thoughts and experiences. We recorded event-related potentials as 39 participants with a range of subclinical depression symptoms, indexed by the Beck Depression Inventory (BDI), read 160 self-relevant probes targeting depression constructs drawn from clinical rating scales and the DSM-5. Participants also read matched non-self-relevant probes describing another person's depression-consistent or depression-inconsistent experiences. Higher BDI scores predicted differences in neural responses to depression-consistent versus depression-inconsistent self-relevant critical words within the first second after word onset. Relative to depression-inconsistent words, depression-consistent self-relevant words elicited (a) smaller N400s (300-500ms), indicating stronger expectations for depression-consistent information that facilitated early meaning access, and (b) larger Late Positive Potentials (LPPs: 600-900ms), indicating greater motivational salience and sustained evaluation. These effects were specific to self-relevant probes and were not explained by general differences in sensitivity to depression-related content or expectancy. Subclinical depression symptom severity is reflected in time-resolved neural activity during comprehension, without overt responses on each trial. These findings link clinically-relevant symptom variation to implicit neurocognitive mechanisms supporting real-time processing of self-relevant information.