搜索结果：Clinical psychology review

Opioid use disorder (OUD) is a global public health crisis that has steadily worsened despite significant efforts. Maladaptive opioid use can have significant negative impacts, yet a minority receive evidence-based treatments. Leveraging common personal technologies like smartphones and computers may help extend access to such services. The current study aims to describe the landscape of personal technology use in opioid use recovery by combining an academic scoping review with a review of commercially available smartphone apps and devices. The scoping review provides an overview of research examining feasibility and efficacy, whereas the commercial review investigates whether available technology is supported by peer-reviewed research or regulatory approval. Four databases were searched for the scoping review (i.e., PubMed, PsychINFO, EMBASE, and MEDLINE) alongside Apple and Google Play stores for the commercial review. Two independent reviewers evaluated the studies. The academic search yielded 937 articles, of which 34 were included, and the commercial review found 21 apps and devices. The included studies show good acceptance and feasibility; however, research reporting on efficacy outcomes is mixed and nascent. Of the commercially available interventions, only eight underwent peer-reviewed evaluation, and only three had received healthcare body approval at the time of the search. Thus, more research is needed to ascertain the efficacy of such interventions, especially in underrepresented groups such as women, minority groups, and insecurely housed people. Additionally, given the limited data identified and the legal and medical risks associated with OUD, further consideration of safety and privacy is warranted. Further, since commercialization has vastly outpaced peer-reviewed research, we suggest amendments to regulatory procedures that consider the risks associated with the intended population, rather than just the intended use. Lastly, we offer suggestions to guide clinical decision-making regarding the use of digital tools in their practice.

Pathogenic variants in AUTS2 are associated with neurodevelopmental disorders, commonly characterized by intellectual disability and autism spectrum disorder. Epilepsy in AUTS2-related syndromes has been reported only in a limited number of patients, usually with scant information on the electroclinical features and longitudinal outcome. We report a proband with AUTS2-related syndrome and performed a narrative literature review. The electroclinical features of our case fall within the spectrum of a developmental/epileptic encephalopathy with spike-wave activation in sleep. This case highlights the importance of a detailed electroclinical characterization of epilepsy in AUTS2-related syndrome and underscores the need for systematic EEG and cognitive monitoring to improve clinical management.

BackgroundX-linked dystonia-parkinsonism (XDP) is a hereditary movement disorder predominantly affecting Filipino males from Panay Island ancestry. Existing research emphasizes molecular and motor aspects, neglecting diagnostic, therapeutic, and psychosocial impacts.ObjectivesTo map the literature on XDP in Filipino men, including its genetic basis, clinical features, diagnostic methods, treatment options, and psychosocial effects.MethodsWe conducted a systematic search following the Joanna Briggs Institute (JBI) methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) principles.ResultsA total of 27 studies were included. Symptoms commenced from localized to widespread dystonia. Parkinsonism manifested within one to two years. Most examined patients exhibited the TAF1 genetic mutation, and diagnosis takes years. Deep-brain stimulation reduced dystonia severity. Pharmacological therapies produced some benefits. Qualitative analysis revealed stigma and identity loss, caregiver burden, financial hardship, and coping and resilience.ConclusionsXDP exhibits a rapid and severe growth trend; however, access to diagnostic tests, modern medicines, and supportive care remains unequal. To address these disparities, it is essential to improve access to genetic and clinical treatments and incorporate psychosocial support systems, including stigma reduction, caregiver assistance, and community networks, into a comprehensive care model.

The serotonin hypothesis of depression is still influential. We aimed to synthesise and evaluate evidence on whether depression is associated with lowered serotonin concentration or activity in a systematic umbrella review of the principal relevant areas of research. PubMed, EMBASE and PsycINFO were searched using terms appropriate to each area of research, from their inception until December 2020. Systematic reviews, meta-analyses and large data-set analyses in the following areas were identified: serotonin and serotonin metabolite, 5-HIAA, concentrations in body fluids; serotonin 5-HT1A receptor binding; serotonin transporter (SERT) levels measured by imaging or at post-mortem; tryptophan depletion studies; SERT gene associations and SERT geneenvironment interactions. Studies of depression associated with physical conditions and specific subtypes of depression (e.g. bipolar depression) were excluded. Two independent reviewers extracted the data and assessed the quality of included studies using the AMSTAR-2, an adapted AMSTAR-2, or the STREGA for a large genetic study. The certainty of study results was assessed using a modified version of the GRADE. We did not synthesise results of individual meta-analyses because they included overlapping studies. The review was registered with PROSPERO (CRD42020207203). 17 studies were included: 12 systematic reviews and meta-analyses, 1 collaborative meta-analysis, 1 meta-analysis of large cohort studies, 1 systematic review and narrative synthesis, 1 genetic association study and 1 umbrella review. Quality of reviews was variable with some genetic studies of high quality. Two meta-analyses of overlapping studies examining the serotonin metabolite, 5-HIAA, showed no association with depression (largest n = 1002). One meta-analysis of cohort studies of plasma serotonin showed no relationship with depression, and evidence that lowered serotonin concentration was associated with antidepressant use (n = 1869). Two meta-analyses of overlapping studies examining the 5-HT1A receptor (largest n = 561), and three meta-analyses of overlapping studies examining SERT binding (largest n = 1845) showed weak and inconsistent evidence of reduced binding in some areas, which would be consistent with increased synaptic availability of serotonin in people with depression, if this was the original, causal abnormaly. However, effects of prior antidepressant use were not reliably excluded. One meta-analysis of tryptophan depletion studies found no effect in most healthy volunteers (n = 566), but weak evidence of an effect in those with a family history of depression (n = 75). Another systematic review (n = 342) and a sample of ten subsequent studies (n = 407) found no effect in volunteers. No systematic review of tryptophan depletion studies has been performed since 2007. The two largest and highest quality studies of the SERT gene, one genetic association study (n = 115,257) and one collaborative meta-analysis (n = 43,165), revealed no evidence of an association with depression, or of an interaction between genotype, stress and depression. The main areas of serotonin research provide no consistent evidence of there being an association between serotonin and depression, and no support for the hypothesis that depression is caused by lowered serotonin activity or concentrations. Some evidence was consistent with the possibility that long-term antidepressant use reduces serotonin concentration. Appeared originally in Mol Psychiatry 2023; 28:3243-3256.

Hypertension is the leading modifiable risk factor for cardiovascular diseases and affects over 1.3 billion adults. The renin-angiotensin and kallikrein-kinin systems (RAS and KKS) are critical in regulating blood pressure (BP). Clinically, the RAS and KKS have gained renewed importance, especially due to the discovery of the non-canonical vasodilative RAS pathway. Thus, for their clinical use, clarity on their measurement and reference ranges is essential. This systematic review aimed to synthesise the reported baseline circulating concentrations of RAS and KKS peptides, and the pre-analytical and analytical methods used in measuing them, in normotensive and untreated hypertensive adults. It adhered to PRISMA guidelines and synthesised data from 27 of 2864 retrieved studies that met the inclusion criteria. Reported peptide concentrations varied widely, ranging from 0.06-81.85 × 103 fmol/mL. However, there was substantial heterogeneity across included studies in sample collection procedures, protease inhibitor use for peptide stabilisation, participant clinical phenotyping, BP reporting, and analytical methods. Reported levels of several RAS and KKS peptides were generally lower in hypertensive cohorts than in normotensive cohorts; however, these differences should be interpreted cautiously given the small number of hypertensive studies, incomplete BP reporting, and substantial heterogeneity across all included studies. Current evidence is insufficient to establish reference ranges for RAS and KKS peptides. This review emphasises the need for standardisation of sampling protocols, comprehensive peptide stabilisation, consistent clinical phenotyping, and robust analytical methods before RAS and KKS peptides can be used as clinical markers and their therapeutic potential identified.

Shaping the work environment in nursing reflects the concept of job crafting, which involves proactive strategies by nurses to redefine tasks, social interactions, and cognitive framing of work, aiming to increase its perceived significance and job satisfaction. The systematic review aims to comprehensively synthesize all relevant research evidence on job crafting within the framework of the healthcare system. A review was conducted, using a systematic search of selected literature related to job crafting in the healthcare system, with a particular focus on nurses. A systematic search was conducted in PubMed/MEDLINE, Scopus, and CINAHL. The search included studies published between January 2015 and January 2025. The prepared review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. A predefined search strategy was systematically applied to the identified records. The work was registered in the PROSPERO database. A total of twenty-five full-text records were included in the final review. Based on the analysis of key domains, such as work engagement (including work efficiency), commitment to work, job satisfaction, intention to remain in the profession, quality of care, and burnout, directions for the development of job crafting were identified. A review of studies indicates that job crafting is positively and significantly associated with work engagement, commitment to work, and job satisfaction (r = 0.22-0.70) and negatively associated with burnout (r = -0.41 to -0.24). Although individual analyses have reported a lack of statistical significance or different directions of dependence, the overall picture confirms the beneficial role of job crafting for employee well-being. Additionally, the analysis highlighted the need for further research in these areas. While numerous studies have examined the concept of job crafting in nursing, the review underscores a persistent gap in the literature, specifically concerning the linkage between employee motivation and proactive modifications of the work environment. Job crafting can help to reduce burnout among nurses by enabling them to adapt their tasks, relationships, and perceptions of work. Higher levels of job crafting are associated with greater work engagement, job satisfaction, and intention to remain in the profession, particularly when it involves modifying tasks and relationships. Job crafting is facilitated by autonomy, a supportive organizational culture, and supervisory support but hindered by rigid procedures, heavy workloads, staff shortages, and limited decision-making opportunities. Although nurses' knowledge, experience, and interpersonal skills are keys to effective job crafting, organizational systems often fail to utilize these competencies.

Phosphodiesterase type 5 inhibitors (PDE5i) are increasingly used beyond the treatment of erectile dysfunction, including for non-medical, performance-oriented purposes among men who have sex with men (MSM). This study aimed to systematically review the literature and meta-analyze the prevalence of recreational or non-medical PDE5i use among MSM and to explore potential sources of between-study heterogeneity. A systematic review and meta-analysis of observational studies was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed/MEDLINE, Scopus, Cochrane Library, and Web of Science were searched from inception to March 2026. Studies reporting quantitative estimates of recreational, non-prescribed, or general PDE5i use among MSM were included. Pooled prevalence estimates were calculated using random-effects meta-analysis of proportions with logit transformation. Sensitivity analyses, subgroup analyses, and assessment of small-study effects using the Doi plot and Luis Furuya-Kanamori index were performed. Five cross-sectional studies including 4390 MSM met the eligibility criteria. Reported prevalence ranged from 16.1% to 53.6%. The pooled prevalence of PDE5i use was 24.4% (95% CI, 16.7%-34.2%; I2 = 97.1%). Exclusion of the main outlier reduced the pooled estimate to 19.1% (95% CI, 17.0%-21.4%; I2 = 62.3%). Prevalence was higher in venue-based than community-based samples (32.4% vs. 19.9%) and in studies with a 6-month compared with a 3-month recall period (21.2% vs. 16.8%). The Luis Furuya-Kanamori index (2.43) suggested major asymmetry, consistent with possible small-study effects. Recreational or non-medical PDE5i use appears common among MSM, affecting approximately one in four individuals overall and approximately one in five after exclusion of the main methodological outlier. Although this represents the first systematic review and meta-analysis addressing this topic, interpretation is limited by the small number of available studies, their cross-sectional design, reliance on convenience sampling, heterogeneous outcome definitions, and substantial between-study heterogeneity. These findings support routine clinical assessment of recreational PDE5i use among MSM, particularly in the context of concomitant illicit drug use, and highlight the need for standardized definitions and more robust epidemiological research.

Patient safety remains a major concern in hospital-based settings because of adverse events, medication errors, communication failures, delayed recognition of clinical deterioration, and inconsistent adherence to safety protocols. Digital health technologies are increasingly used to support patient safety, but their contribution may depend on integration with standardized protocols and multidisciplinary workflows. This scoping review aimed to map evidence on the integration of digital health technologies and standardized protocols for supporting patient safety in hospital-based settings. This scoping review followed the Arksey and O'Malley framework, further refined by Levac et al, and was guided by PRISMA-ScR. PubMed, Scopus, CINAHL, Web of Science, and IEEE Xplore were searched for English-language studies published from 2006 to June 2025. Eligible studies examined digital health technologies integrated with standardized protocols in hospital-based care and reported patient safety-related outcomes. Data were synthesized using descriptive content analysis and thematic synthesis. Twenty studies were included. Four themes were identified: algorithm-based early warning systems for patient deterioration and sepsis risk; barcode medication administration, electronic medication reconciliation, and clinical decision support systems for medication safety; standardized handoff protocols and digital checklists for clinical communication and workflow adherence; and electronic monitoring systems and digital safety toolkits for hand hygiene and fall prevention. Included studies reported study-specific outcomes related to mortality, length of stay, medication errors, adverse drug events, communication accuracy, protocol adherence, hand hygiene compliance, and fall-related outcomes. Digital health technologies may support patient safety when aligned with standardized protocols and embedded in multidisciplinary workflows. Because no formal critical appraisal or quantitative synthesis was conducted, findings should be interpreted as evidence mapping rather than definitive evidence of effectiveness. Future studies should examine implementation quality, alert fatigue, staff training, workflow integration, sustainability, and transferability across hospital contexts.

The rapid integration of AI chatbots powered by large language models (LLMs) into daily life has been accompanied by reports of psychosis-like presentations following intensive human-AI interaction, a phenomenon we provisionally label AI-induced psychosis as a working construct rather than a validated clinical entity. This hypothesis-generating narrative review synthesizes case reports from media accounts, court documents, and a recently published case compilation, together with theoretical frameworks from clinical psychiatry, cognitive science, and human-computer interaction, to propose a conceptual model for further empirical investigation. We hypothesize that AI-induced psychosis arises through a human-AI delusional feedback loop, in which AI sycophancy may amplify emotional vulnerabilities, such as loneliness, anxiety, and depression, creating a self-reinforcing cycle that could co-construct and consolidate delusional beliefs. Drawing on distributed cognition theory and the Computers Are Social Actors (CASA) paradigm, we propose that AI chatbots may function as both a complementary cognitive tool and a relational "Quasi-Other," providing sycophantic verification that may transform delusional beliefs into an apparent shared reality. Four recurring delusional themes are tentatively identified from reported cases. We further compare AI-induced psychosis with schizophrenia, while acknowledging that several distinctions remain hypothesized rather than empirically established. The label AI-induced psychosis is used phenomenologically, not to assert causal certainty; whether AI chatbots cause, precipitate, reinforce, or merely organize the thematic content of pre-existing psychopathology requires longitudinal study. This review aims to lay conceptual groundwork for clinical recognition and to guide future empirical investigation into whether AI-induced psychosis represents a distinct phenomenon or a variant of established disorders.

Individual studies have highlighted elevated rates of post-traumatic stress disorder (PTSD) in cohorts of people with functional / dissociative seizures; however, prevalence estimates vary and the strength of the association between FDS and traumatic symptoms is contested. In the current review, we meta-analyse studies reporting the co-occurrence rate of PTSD and FDS before exploring sources of heterogeneity through moderator analysis. Systematic searches were performed in July 2025 in Scopus, MEDLINE and PsycInfo. We included studies reporting the proportion of adult FDS cohorts with clinically diagnosed or probable PTSD (e.g., passing thresholds on PTSD screening instruments). The Joanna Briggs Institute Quality Appraisal Tool was used to assess the quality of included studies. The random effects meta-analysis included 34 studies representing data from 31,711 individuals with FDS. The pooled effect size (PTSD and FDS co-occurrence) was 37.7% (95% CI = 30.0 - 45.6%). Between-study heterogeneity was partially explained by sample frame (clinical or non-clinical settings), risk of bias, and the method used for identifying PTSD. Studies of higher quality reported higher rates of comorbidity. Approximately one-third of those with FDS had been diagnosed with PTSD or were exhibiting symptoms likely to meet the diagnostic criteria for PTSD. Although this finding is clinically significant, most individuals with FDS do not meet this criterion, indicating PTSD is not a universal feature in the FDS population. Future meta-analyses would benefit from utilising individual patient data to enhance moderator interpretation.

Cognitive impairment is a frequent feature of bipolar disorder (BD), often persisting during euthymic phases and affecting multiple cognitive domains. These deficits impair functional recovery and quality of life. Pharmacological treatments have shown limited efficacy in ameliorating cognitive dysfunction in BD. Cognitive remediation (CR) has emerged as a promising nonpharmacological alternative. However, reviews of its efficacy in BD have reported inconsistent findings. One major limitation highlighted in past reviews is the heterogeneity of study samples, due to the inclusion of participants without cognitive impairment, potentially introducing a ceiling effect that may obscure treatment benefits. This review addresses this gap by examining only studies that selected participants through objective or structured subjective cognitive screening. A systematic search of PubMed and Web of Science (finalized 27 January 2026) identified interventional studies of CR in adults with BD requiring objective or subjective cognitive impairment for inclusion. Of 2662 records retrieved, 128 full texts were reviewed, and 6 studies met eligibility criteria; 2 secondary analyses derived from 2 of these studies were also retained for synthesis. Four studies were randomized controlled trials, one was non-randomized with a control group, and one was uncontrolled. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Given methodological variability, results were synthesized narratively. Six studies met inclusion criteria. Findings were inconsistent: three reported significant cognitive improvements following CR or related interventions, whereas three randomized trials found no significant cognitive effects. Variability in screening methods, intervention formats, and outcome selection precluded meta-analysis. Evidence is constrained by the small number of eligible studies, methodological heterogeneity, and variable risk of bias. Current evidence from enriched samples suggests that CR may improve specific cognitive domains in BD, but overall results remain inconclusive. Future trials should employ rigorous cognitive screening, harmonized outcome measures, and more individualized interventions to clarify efficacy. PROSPERO registration ID: CRD42025642423.

Despite strong evidence supporting exclusive breastfeeding (EBF) for the first six months of life, global and national rates remain suboptimal. In the critical first 48-72 hours after birth, several widespread clinical practices and beliefs, unsupported by current evidence, may inadvertently undermine breastfeeding initiation and continuation in healthy term neonates. To critically examine the available evidence on three clinical practices that may compromise early breastfeeding establishment in healthy term neonates: the perception that colostrum volumes are insufficient for the newborn's needs, the routine restriction of pacifier use, and the early introduction of electric breast pumps as a substitute for direct breastfeeding or hand expression. Narrative review of evidence from randomised controlled trials, systematic reviews, meta-analyses, and observational cohort studies, addressing three evidence-practice gaps relevant to the first 48-72 hours postpartum: (1) the physiology of colostrum production and the mismatch between normal volumes and maternal/professional expectations; (2) the effect of pacifier use on breastfeeding outcomes in term infants; and (3) the impact of breast pump use in the first days of life on breastfeeding duration and exclusivity. Colostrum volumes (2-10 mL per feed, 30-60 mL/day in the first 72 hours) are physiologically matched to neonatal gastric capacity and metabolic needs; perceived insufficient milk supply is overwhelmingly driven by unrealistic expectations rather than true lactation failure. Randomised evidence shows that small-volume, structured formula supplementation does not compromise breastfeeding duration, and that pacifier use in healthy breastfeeding term infants does not reduce breastfeeding rates. Routine introduction of electric breast pumps in the first days of life is associated with shorter breastfeeding duration; hand expression yields greater colostrum volumes and is associated with higher breastfeeding rates at two months than electric pumping. Evidence-based counselling on colostrum sufficiency, individualised pacifier counselling, and prioritisation of hand expression over routine electric pump use in the first 48-72 hours could meaningfully improve breastfeeding outcomes in healthy term neonates. Future research should prioritise pragmatic cluster-randomised trials evaluating bundled interventions in routine maternity care settings.

The aim of this systematic review was to synthesize current evidence on end-of-life (EOL) communication in surgical and neurocritical care settings. While effective EOL communication is essential to support patient-centered decision-making and ethical care, its implementation in surgical and neurosurgical contexts remains inconsistent and insufficiently characterized. Using advanced search terms, a systematic review of the literature was conducted, comprising PubMed and Scopus. Studies published from January 2016 to January 2026 were included if they involved adult patients, family members, or clinicians engaged in EOL communication within surgical, neurosurgical, or oncological settings and reported empirical data on communication practices, barriers, ethical issues, family involvement, or training interventions. Observational, interventional, and qualitative studies were eligible. Due to substantial heterogeneity in study design and outcomes, findings were synthesized qualitatively. Twenty-six studies met the inclusion criteria. Across studies, EOL communication was characterized by significant challenges related to time constraints, emotional burden, prognostic uncertainty, and variability in clinician communication skills. Structured training interventions, particularly simulation-based programs, were associated with improved clinician confidence and perceived competence, although their implementation was inconsistent. Neurosurgical and neuro-oncological settings presented distinct challenges, including rapid disease progression, early cognitive impairment, and increased reliance on family members for surrogate decision-making. Ethical dilemmas surrounding medical futility, autonomy, and conflict resolution were recurrent. The available evidence highlights persistent gaps between recommended and actual EOL communication practices in surgical and neurocritical care. Improving outcomes will require earlier and structured communication, formal training embedded in surgical education, and multidisciplinary collaboration. Future research should prioritize prospective designs and standardized outcome measures to strengthen the evidence base and support more informed clinical decision-making for patients, families, and clinicians. Systematic review registration no.: CRD420261320726 (www.crd.york.ac.uk/prospero/).

Chronic musculoskeletal pain (CMSKP) in adolescence is associated with physical, psychological, social, and academic impairment and increased risk for chronic pain in adulthood. Although physical activity interventions are an evidence-based approach for managing pediatric chronic pain, many adolescents with CMSKP avoid physical activity due to fear of increased pain, low confidence in physical functioning, and other pain-avoidance behaviors. Resilience-focused interventions targeting self-efficacy, motivation, and mental flexibility may improve engagement in valued activities despite pain. This study describes the design and protocol of the Pain REsilience Promotion for Youth (PREP-Y) intervention, a resilience-focused physical activity intervention for adolescents with CMSKP. This single-site, pilot phase 2, single-group, non-randomized clinical trial will enroll 40 adolescents aged 12-17 years with CMSKP from Nationwide Children's Hospital in Columbus, Ohio, USA. Participants complete questionnaires, objective physical functioning assessments, and physical activity monitoring using activPAL devices as baseline measures. Participants then complete 4 virtual resilience-focused intervention sessions targeting pain resilience, self-efficacy, motivation, and adaptive coping related to physical activity. Garmin watches are used to track activity during the intervention period. Follow-up assessments occur post-intervention and at 3 months post-intervention. Primary outcomes include feasibility and acceptability, assessed through recruitment, retention, attendance, intervention fidelity, and completion of study measures. Exploratory outcomes include physical activity, sedentary behavior, pain-related functioning, pain catastrophizing, kinesiophobia, self-efficacy, and resilience-related constructs. The study was approved by the Nationwide Children's Hospital Institutional Review Board. Findings will inform a future randomized clinical trial. This manuscript reflects protocol version 5.0 dated 23 March 2026. ClinicalTrials.gov NCT06923891.

Despite the efficacy of antipsychotics, medication non-adherence remains common among individuals with a First Episode of Psychosis (FEP). A systematic review was conducted in accordance with the PRISMA 2020 guidelines to summarise the existing evidence base regarding the reasons, attitudes, and beliefs underlying both medication non-adherence and adherence in FEP, as well as psychosocial interventions designed to promote medication adherence in psychosis. Seventy-six studies were eligible for inclusion. Nineteen reasons for medication non-adherence in FEP were identified, which were synthesised into 10 overarching themes: Insight and Perceived Need, Autonomy and Control, Trust and the Therapeutic Relationship, Cultural and Spiritual Factors, Side Effects and Perceived Inefficacy, Social and Family Influences, Stigma, Practical Barriers, Substance Use and Symptom-Driven Factors. Facilitators of adherence included illness insight, motivation to recover and fear of relapse, trust in clinicians, acceptance of the bio-psychosocial model, experiencing positive treatment outcomes, use of digital reminders and social support. A range of psychosocial interventions demonstrated effectiveness for enhancing medication adherence in psychosis. This included Cognitive Behaviour Therapy, psychoeducation, motivational interviewing, adherence therapy, assertive community treatment, and adherence-focused psychosocial skills training, particularly when delivered in combination. Medication non-adherence in FEP is shaped by a complex interplay of personal, relational, cognitive, cultural and systemic influences. Addressing these factors in the design and delivery of psychosocial interventions may serve to improve medication adherence outcomes in early psychosis. To support clinical application, this review also provides a fictitious clinician-client transcript along with Socratic questions and CBT strategies to assist clinicians in assessing and promoting medication adherence in FEP.

Domestic violence remains a major public health challenge with profound consequences for women survivors. Arts-based interventions are increasingly incorporated into community services as culturally responsive recovery approaches for marginalized populations; however, it remains unexamined whether quantitative evaluation frameworks adequately capture their broad intended outcomes. This scoping review mapped the literature on arts-based interventions for survivors, examining the ecological alignment-or potential evaluative tension-between stated objectives and quantitative evaluation metrics. Conducted following established scoping review methodology and reporting guidelines, systematic searches of Web of Science, Scopus, PubMed, and PsycINFO identified 12 eligible empirical studies. Data were charted using the Social Ecological Model across individual, interpersonal, and community levels. Findings revealed interventions were predominantly community-integrated, with objectives extending beyond psychological symptom reduction to encompass peer connection, cultural belonging, and collective healing. While individual-level recovery was evaluated using congruent psychological measures, broader interpersonal and community-oriented goals were less consistently represented. This revealed an evaluative tension, wherein relational and community outcomes were only partially reflected in formal quantitative assessments. Although arts-based interventions operate across multiple ecological levels, current evaluations remain disproportionately focused on individual psychological outcomes. Future research and policy initiatives may benefit from developing ecologically responsive measurement approaches that capture relational and community-level outcomes alongside clinical measures, thereby providing rigorous evidence to inform the funding, implementation, and evaluation of public health programs for women survivors of domestic violence.

Polycystic ovary syndrome (PCOS) negatively impacts women's metabolic health, reproductive hormones, and psychological well-being. The aim of this study was to systematically evaluate the efficacy of mindfulness-based interventions (MBIs), such as yoga and mindfulness meditation, on anthropometric indices, metabolic profiles, reproductive hormones, and quality of life in women with PCOS. A systematic review and meta-analysis was conducted with 10 randomized controlled trials (RCTs) involving 356 participants, selected from databases including PubMed and Cochrane Library up to January 2025. Data were synthesized using Review Manager 5.3 to calculate mean differences (MDs) and standardized mean differences (SMDs). Women in the MBI groups showed significant reductions in BMI, body weight, abdominal circumference, and preliminary improvements in insulin resistance (HOMA-IR; based on two studies), alongside improvements in total testosterone levels and clinical hirsutism. Although generic depression and anxiety scores did not show significant differences, disease-specific quality of life improved significantly. MBIs show potential as metabolic and endocrine modulators and may offer benefits in insulin sensitivity, weight management, and hyperandrogenism beyond mere stress reduction for women with PCOS.

Pharmacists are expanding their participation in veterinary healthcare teams and assuming roles beyond traditional dispensing duties. However, the scope of these collaborative practices and the degree of mutual recognition vary substantially across regions. This scoping review aimed to organize the existing literature on collaboration between veterinarians and pharmacists, clarifying current roles, practical applications, and professional perceptions within the veterinary field. A scoping review was conducted to examine the roles, practices, and perceptions associated with veterinarian-pharmacist collaboration in veterinary medicine and related fields. Two researchers independently searched PubMed, Web of Science, the Cochrane Library, and Ichushi-Web, and additionally screened Google Scholar to identify gray literature (from database inception to August 2025, in English or Japanese). Records were independently screened at the title/abstract and full-text levels using predefined eligibility criteria, and relevant studies were identified. The search yielded 239 records, of which 16 studies published between 2007 and 2024 were included. Studies were conducted primarily in the United States (n = 7), New Zealand (n = 3), and Japan (n = 3); one study collected data from both Japan and Taiwan. Most studies employed cross-sectional survey designs. Pharmacist roles most frequently involved compounding and dispensing for animal patients (62.5%), followed by drug information (DI) and consultation (37.5%), inventory and supply management (25.0%), client education (18.8%), and safety and exposure control (12.5%). This scoping review demonstrates that veterinarian-pharmacist collaboration is described within a limited and regionally variable evidence base, with pharmacists most often contributing through compounding/dispensing and drug information support. Sustained and scalable implementation will require improved mutual understanding of professional roles, strengthened veterinary-specific education for pharmacists, and more robust empirical research to inform collaborative practice models.

Alzheimer's disease is increasingly defined by biomarker evidence of amyloid-β and tau pathology, sharpening questions about whether late-life depression contributes to, or instead reflects, this pathology. We conducted a systematic review and meta-analysis of studies published between 2000 and 2025 that compared amyloid-β biomarkers in adults with and without depression, with depression defined by validated clinical diagnoses or symptom rating scales. Twenty-four studies were included, spanning three biomarker sources: cerebrospinal fluid, positron emission tomography imaging, and plasma. Across all sources, the pooled difference in amyloid-β burden between depressed and non-depressed individuals was small and clustered near zero, indicating only a weak, statistically non-significant tendency toward higher amyloid in depression. When the three sources were examined separately, each yielded a similar near-null result, although between-study heterogeneity was considerable for cerebrospinal fluid and plasma and moderate for imaging. Importantly, a prespecified subgroup analysis showed that imaging results diverged by quantification method: studies using the simpler standardized uptake value ratio clustered around zero, whereas the smaller group of studies using kinetic distribution volume ratio modelling showed a significant positive association, suggesting that methodological choices critically influence the observed relationship. Taken together, these findings indicate that depression is not consistently accompanied by greater amyloid-β burden across widely used biomarker platforms. The distribution volume ratio signal nonetheless raises the possibility of subtle associations that cruder methods may obscure, and suggests that depression may shape Alzheimer's disease trajectories more by modifying the clinical impact of amyloid than by altering its amount.