Numerous studies have examined the relationship between parental psychological control and social anxiety among children and adolescents; however, findings are inconsistent, and existing hypotheses are conflicting. Therefore, the present study employed a three-level meta-analysis to synthesize the association between parental psychological control and social anxiety in children and adolescents. After systematic literature searching and screening, 36 studies were included, yielding 192 effect sizes and a total sample of 29,815 participants. The results showed a positive correlation between parental psychological control and social anxiety in children and adolescents. Moderator analyses indicated that parental gender, culture, type of social anxiety, type of parental psychological control, and publication year significantly moderated this association. Specifically, maternal psychological control was more strongly associated with social anxiety than paternal psychological control. Parental psychological control was more strongly associated with fear of negative evaluation and social avoidance and distress in general situations than with social avoidance and distress in unfamiliar situations. In addition, authority assertion and love withdrawal were more strongly associated with social anxiety than guilt induction. The association between parental psychological control and social anxiety also appeared to become stronger over time. Moreover, parental psychological control was more strongly associated with social anxiety in Eastern cultures than in Western cultures. However, the culture moderator should be interpreted with caution because of the imbalance in the number of effect sizes across cultural contexts. These findings suggest that parental psychological control is an important correlate of social anxiety in children and adolescents and highlight the need for further longitudinal and cross-cultural research.
Research has consistently linked political ideology to vaccination intentions, adherence to non-pharmaceutical interventions (NPIs), and psychological reactance. However, less is known about whether these associations are contingent upon governance style. Using the COVID-19 pandemic as a naturalistic context, the present study examined whether collaborative versus confrontational governance styles would shape the relationship between political ideology and public health compliance. Spanish (n = 336) and Norwegian (n = 308) participants completed an online survey between April and May 2021 assessing political ideology, psychological reactance, attitudes toward NPIs, and vaccination intentions. Independent samples t-tests and chi-square analyses examined group differences, and moderation analyses tested whether national context conditioned associations between political ideology and the outcome variables. Spanish participants exhibited higher political polarization and stronger psychological reactance than Norwegians. The sociopolitical context significantly moderated the relationships between political ideology and all outcome variables. In Spain's more polarized and confrontational governance context, a shift toward the political right was associated with lower vaccination intentions, more negative attitudes toward NPIs, and stronger psychological reactance. In Norway's consensus-oriented governance context, these associations were substantially attenuated or negligible. These findings suggest that political ideology does not uniformly predict psychological reactance and health behaviour: confrontational governance styles may intensify political polarization and resistance to public health measures, whereas collaborative and consensus-oriented governance may buffer such effects. By highlighting that macro-level political environments may shape individual motivational processes, this study advances theory at the intersection of political psychology and health behaviour, highlighting the importance of context-sensitive communication in future health crises.
Psychological distress and motor impulsivity may be key factors associated with love addiction. However, the possible mediating role of specific emotion regulation difficulties in this association needs further research. This study examined the direct and indirect associations of psychological distress and motor impulsivity with love addiction, as well as the potential mediating role of emotion regulation difficulties among a sample of 714 participants (Mage = 26.00, SD = 10.16; 68.2% women). Furthermore, we tested for structural gender invariance. The results indicated that psychological distress and motor impulsivity were directly and positively associated with love addiction. Crucially, they were indirectly associated with love addiction, partially and exclusively, via the lack of emotional control. This mediational pathway was notably stronger for psychological distress than for motor impulsivity. Additionally, multigroup analysis confirmed that the structural model was strictly invariant across genders. These findings suggest that a lack of emotional control partially accounts for the relationship between psychological vulnerabilities and love addiction. This provides empirical evidence that individuals experiencing distress and impulsivity are more likely to report a compulsive reliance on romantic relationships as a maladaptive coping strategy, highlighting the need to target impulse control under emotional duress in clinical settings.
Perineal injuries remain a common complication of vaginal birth, particularly among primiparous women. This study assessed the effects of a perineal heat stimulation-massage plus pre-adaptation protocol, started at 34 weeks of gestation, on perineal outcomes and maternal psychological well-being in primiparous women. This retrospective cohort study enrolled 500 primiparous women who delivered at Jiangxi Maternal and Child Health Hospital between May 2025 and October 2025. Participants were divided into an intervention group (n = 247) and a control group (n = 253) based on antenatal records and self-reports of receiving the structured protocol. Outcomes compared between the two groups included perineal injury, duration of all labor stages, postpartum blood loss within 2 hours, perineal pain at 48 hours, neonatal Apgar scores, and maternal psychological well-being assessed using the Childbirth Self-Efficacy Inventory (CBSEI) and the State-Trait Anxiety Inventory (STAI). Compared with routine care, the intervention group had a significantly better rate of intact perineum (34.01% vs. 15.02%, p < 0.001) and lower rates of both episiotomy (36.03% vs. 46.25%, p = 0.020) and perineal tears (29.96% vs. 38.74%, p = 0.039). Labor progressed more efficiently in the intervention group, with shorter median durations of the first (439 vs. 514 min), second (55 vs. 74 min), and third stages of labor (8 vs. 12 min). The intervention group also had reduced median postpartum blood loss within 2 hours (233 vs. 244 mL) and lower perineal pain at 48 hours (Visual Analog Scale [VAS] 3 vs. 4; p < 0.001). Furthermore, women in the intervention group reported significantly higher childbirth self-efficacy (CBSEI, 108 vs. 94 scores, p < 0.001) and lower state anxiety (STAI 35 vs. 41 scores, p < 0.001). The two groups did not differ in neonatal outcomes, including Apgar scores. The "antenatal heat stimulation-massage combined pre-adaptation protocol" was associated with reduced perineal injury and more efficient labor, along with lower postpartum distress and improved childbirth experience through psychological empowerment, without adverse effects on neonatal outcomes. These observations support the approach as a practical, non-pharmacological antenatal care framework and inform future prospective studies assessing the integrated mind-body preparation model in maternity care.
The first 1,000 days of life represent a critical phase for child development and may have a significant impact on parents' psychological functioning. While numerous studies have focused on mothers, limited data are currently available regarding the potential psychological changes experienced by fathers during this perinatal period. This study aimed to explore the fathers' mental health during the perinatal period. A prospective cross-sectional study was conducted among 76 French-speaking fathers in Belgium. Participants were divided into two groups: fathers in the perinatal period (n = 51) and fathers outside the perinatal period (n = 25). Data were collected through an online questionnaire that included demographic measures and psychometric scales (Beck Depression Inventory, State-Trait Anxiety Inventory, Alcohol Use Disorders Identification Test, Adverse Childhood Experiences and Adult Resilience Scale). After adjusting for potential confounding factors, resilience scores remained significantly higher among fathers in the perinatal period compared to those outside this period (p = .025). Conversely, no significant differences were observed for other psychometric measures (depression, anxiety, alcohol consumption or exposure to adverse childhood experiences) (p > .05). Moderate levels of anxiety were present in both groups. This study underscores the potential importance of better addressing fathers' mental health during the perinatal period. The findings suggest the value of continuous and tailored psychological support for fathers throughout their parenting journey. In this context, assessing resilience could represent a potentially useful avenue for prevention and psychological monitoring, although this needs to be confirmed in other studies. Further research is needed to better understand the evolution of paternal mental health over time.
Family life satisfaction has a protective role against stressful life events. Increased satisfaction with family life contributes to the well-being of individuals. This study aimed to examine the longitudinal mediating role of psychological resilience in the relationship between family life satisfaction and mental well-being. The sample consisted of 261 Turkish emerging adults (139 females, 53.3%) aged between 18 and 27 (M = 20.63, SD = 1.89). Participants completed the Satisfaction with Family Life Scale, Resilience Scale, and Warwick-Edinburgh Mental Well-Being Scale Short Form. In order to explain the relationship, a cross-lagged panel study in two waves was conducted. The results revealed that psychological resilience longitudinally mediates the relationship between family life satisfaction and mental well-being. This research indicates that family life satisfaction increases psychological resilience, which in turn influences mental well-being. The findings of the study were discussed and interpreted in detail in light of the relevant literature.
Living kidney donation prior to euthanasia has never previously been reported and is not incorporated into current clinical guidelines. This study aims to discuss the unique medical, procedural, psychological and ethical considerations of living donation prior to euthanasia based on 3 Dutch cases. Of the 3 candidates, 2 successfully donated without detrimental effects to physical or mental health; one was declined for medical reasons. In two cases, euthanasia has been performed; in one case donation was transformative and the request for euthanasia was withdrawn after donation. Medically, normal life-expectancy after donor nephrectomy should be presumed as euthanasia remains uncertain. Procedurally, timing can create tension between these two processes as postponing euthanasia could be harmful. Psychologically, potential exacerbation in psychopathology should be weighed against the impact of being declined for donation. Ethically, autonomy, capacity to consent and risk-benefit ratio must be rigorously assessed, especially given the degree of suffering in these cases. We conclude that living donation and euthanasia should be seen as independent processes and a euthanasia request should not be considered an absolute contra-indication for living donation. Our initial experiences underscore the need for international dialogue and policy development.
Daily activities, work, and health are closely intertwined. We closely followed 45 participants aged 50-66 years working across different sectors in a year-long study, who completed a range of baseline, weekly, and monthly Participant Reported Outcome Measures (PROMs). Participants self-reported on work-related aspects using the Brief Job Stress Questionnaire (BJSQ) and Workplace Wellbeing Question Bank (WWQB); wellbeing using the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS); and sleep using the Pittsburgh Sleep Quality Index (PSQI). Additionally, they provided wrist-worn actigraphy data collected over three periods (each period ~ 35-40 days). In total, we collected 1901 PROMs entries and 5258 days of actigraphy data. We computed 55 actigraphy measures broadly assessing physical activity, sleep, and diurnal variability characteristics. We explored statistical associations between pairs of PROMs items and between PROMs items with actigraphy measures using correlations and cross-correlations to assess similarities. We built mixed-effects models to associate PROMs items and actigraphy measures with global PSQI and total WEMWBS. We found very strong associations (>|0.5|) between BJSQ items with total WEMWBS and global PSQI, highlighting certain work aspects affect sleep and overall wellbeing, whereas actigraphy analysis provided new insights uncovering sleep quality problems including disturbances and awakenings for most participants. Additionally, the mixed-effects models revealed that actigraphy-derived sleep measures are strongly associated with total WEMWBS and global PSQI providing complementary information to PROMs. Integrating longitudinal work-related self-reports and actigraphy can provide useful personalized wellbeing- and health-insights, and should likely be considered in future smart-health monitoring systems to promote healthy aging.
How paternity leave relates to postpartum adjustment remains unclear. We examined associations of paternity leave group [no leave, short (<1 month), or long (≥1 month)] with mothers' parenting adaptation and depressive symptoms at 3 months postpartum in a theory-guided SEM including mothers' reports of fathers' childcare and housework involvement and perceived coparenting quality. This cross-sectional survey included 555 mothers (primipara, n = 330; multipara, n = 225). Participants completed questionnaires assessing fathers' involvement using the Child Care Activities and Housework Scale, coparenting quality using the Coparenting Relationship Scale, parenting resilience and adaptation using the Comprehensive Scale for Parenting Resilience and Adaptation, and depressive symptoms using the Center for Epidemiologic Studies Depression Scale. Parity-stratified SEM estimated associations. In primiparous families, short and long leave were associated with higher paternal involvement; long leave had stronger associations across all four domains: Interactional Activities, Concrete Childcare Activities, Mental Support, and Housework. In multiparous families, leave was associated mainly with housework and task-based childcare, but not clearly with mental support. Across parity groups, mothers' reports of fathers' mental support showed the strongest association with mothers' perceived coparenting quality [primipara: β = 0.411, 95% CI (0.285, 0.527); multipara: β = 0.490, 95% CI (0.350, 0.612)]. Better coparenting was associated with fewer perceived difficulties in environmental resources and perceived support and with lower psychological maladaptation to parenting; psychological maladaptation was positively associated with depressive symptoms in both groups [primipara: β = 0.396, 95% CI (0.178, 0.571); multipara: β = 0.301, 95% CI (0.133, 0.459)]. Because no direct paths from paternity leave to depressive symptoms were specified, total effects represented indirect associations. These associations were small and negative for both short and long leave among primiparous mothers; among multiparous mothers, only short leave showed a small negative indirect association, whereas the association for long leave was not clearly supported. Paternity leave duration showed small indirect associations with maternal parenting adaptation and depressive symptoms through fathers' involvement and coparenting quality. The findings suggest that the potential relevance of leave may depend not only on uptake and duration but also on supportive involvement and coparenting.
Genomic medicine is expanding across Latin America (LATAM), yet access to essential ancillary services such as genetic counselling remains limited. 'Latin-SEQ' is a study that provides whole exome sequencing (WES) for neuromuscular diseases across 18 countries, aiming to improve diagnostic rates and generate region-specific genetic insights. However, funding constraints exclude genetic counselling and cascade testing, raising concerns about equitable and harm-free care. This paper reports early findings from 'Latin-SEQ Plus,' a mixed-methods study exploring patient and healthcare practitioner (HCP) perspectives on WES and genetic counselling. Data were generated via surveys with patients and HCPs, and participatory workshops with HCPs across six countries. We found that patients strongly valued genetic testing for diagnostic clarity, improved care, and family planning. HCPs acknowledged the diagnostic benefits of WES but highlighted absence of local genetic counselling services, inconsistent pre and post-test practices, and uncertainty in managing incidental findings and variants of uncertain significance (VUS). Psychological impacts related to WES results are not always addressed, underscoring risks of psychological and emotional harm for patients. Access to WES and genetic counselling is limited in LATAM due to financial hardship and the absence of a clear genetic counselling infrastructure. Our findings also reveal a mismatch between patient expectations and HCPs' capacity to deliver comprehensive genomic care. We argue for urgent investment in genetic counselling infrastructure, HCP training, culturally tailored resources, and policy frameworks to support equitable implementation of genomic medicine in LATAM.
Depression and other psychological disorders significantly affect cancer patients' quality of life and treatment outcomes. Despite this recognition, comprehensive data on antidepressant prescription patterns in cancer care settings throughout the world remain limited. This study aimed to analyze antidepressant prescription patterns among patients with cancer and variations across medical departments, pharmacological effects, clinical symptoms, and treatment modalities. A retrospective chart review of antidepressant prescriptions was conducted at Chiba Cancer Center between January 1 and December 31, 2022. Patient demographics, primary department visits, types of antidepressants, reasons for prescription, and concurrent cancer treatments were evaluated. Among 20,440 patients with cancer, 214 (1.1%) received antidepressant prescriptions. The mean age was 63.9±13.0 years, with female patients (61%) receiving prescriptions more frequently than males (39%). The prescription proportions were highest for patients who visited multiple departments (2.7%), those receiving palliative care (1.9%), and those who underwent breast surgery (1.6%). Serotonin-norepinephrine reuptake inhibitors (29%) and serotonin antagonists and reuptake inhibitors (28%) were the most commonly prescribed antidepressants. The primary reasons for prescription were insomnia (38%), pain and numbness (31%), and depression (23%). The majority of prescriptions were initiated during chemotherapy (33%) or surgery (19%). This study revealed a relatively low proportion of antidepressant prescriptions among patients with cancer compared with previous reports. Prescriptions were more common in female patients and in those receiving care from multiple departments. Physical symptoms, rather than depression, are the primary drivers of antidepressant prescriptions. These findings suggest a need for enhanced psychological assessment and support in cancer care settings.
E-cigarette use or 'vaping' is increasing globally. Withdrawal symptoms have been extensively researched in tobacco users, but less is known regarding withdrawal among e-cigarette users. We aimed to explore the type, relative frequency, and severity of withdrawal symptoms experienced by e-cigarette users in Saudi Arabia. A cross-sectional survey was administered to e-cigarette users aged ≥18 years residing in Saudi Arabia in 2023, using a convenience sampling frame. The primary outcome is the withdrawal symptoms. Descriptive statistics and correlations were employed to analyze the data. Data from 339 participants were analyzed: 87% males, 66% students, 90% used nicotine-containing e-cigarettes, with 55% using higher strength nicotine concentrations (>18 mg/mL). The most frequently reported psychological withdrawal symptoms were intense cravings for nicotine (43%), anger (29%), restlessness (28%), and poor concentration (20%), while 71% of participants reported experiencing at least one withdrawal symptom. The most commonly reported physical withdrawal symptoms were headache (34%), dizziness (17%), heart palpitations (15%), and breathing difficulties (14%). Approximately 42% of participants reported moderate-to-severe withdrawal symptoms. Notably, 36.9% returned to smoking to alleviate withdrawal symptoms. E-cigarette users in Saudi Arabia experienced a range of psychological and physical withdrawal symptoms. Psychological symptoms were more commonly reported than physical ones. Further studies are warranted to elucidate the factors influencing the occurrence and severity of these symptoms.
To propose the Health Research Standard Process for Artificial Intelligence framework, adapted from the Cross-Industry Standard Process for Data Mining approach, and apply it using time series and artificial intelligence techniques to analyze data from the Sistema de Informação de Agravos de Notificação (SINAN - Notifiable Diseases Information System) on violence against women in São Paulo, exploring sociodemographic, spatial, and predictive dimensions. The methodology was adapted to health research, replacing the original Business Understanding stage with Research Understanding by incorporating essential technical-scientific elements. We analyzed 80,148 reports of violence against women aged between 20 and 59 living in the city of São Paulo between 2013 and 2023. The analyses included descriptive statistics, calculation of prevalence ratios, decomposition and predictive modeling of time series capturing trends and seasonality, and geospatial analysis of notifications. We observed temporal patterns and sociodemographic characteristics of the victims, with increasing trends in reports of physical, psychological, and sexual violence after 2015 and seasonal behavior. Among the associations, there was a 32% increase in the prevalence of sexual violence when the aggressor was under the influence of alcohol and a 2.47 times greater risk of sexual violence among pregnant women. The geospatial distribution revealed concentrations of notifications in peripheral areas of the municipality, such as the south, east, and central zones. Predictive modeling indicated that the upward trend will persist over the next 24 months, with estimated rates reaching up to 12 cases per 100,000 inhabitants. The applicability of the Health Research Standard Process for Artificial Intelligence was effective as a model for data analysis and the development of predictive algorithms in public health. It was possible to propose a replicable methodological matrix for future research and evidence-based interventions. Propor o framework Health Research Standard Process for Artificial Intelligence, adaptado da abordagem Cross-Industry Standard Process for Data Mining e aplicá-lo por meio de técnicas de séries temporais e inteligência artificial na análise dos dados do Sistema de Informação de Agravos de Notificação sobre violência contra mulheres em São Paulo, explorando dimensões sociodemográficas, espaciais e preditivas. A metodologia foi adaptada às pesquisas em saúde, substituindo a etapa original do Business Understanding por Research Understanding ao incorporar elementos técnico-científicos essenciais. Foram analisadas 80.148 notificações de violência contra mulheres entre 20 e 59 anos, residentes no município de São Paulo, no período de 2013 a 2023. As análises incluíram estatísticas descritivas, cálculo de razões de prevalência, decomposição e modelagem preditiva de séries temporais capturando tendências e sazonalidade, e análise geoespacial das notificações. Observou-se padrões temporais e características sociodemográficas das vítimas, com tendências crescentes nas notificações de violência física, psicológica e sexual após 2015 e comportamento sazonal. Entre as associações, identificou-se aumento de 32% na prevalência de violência sexual quando o agressor estava sob efeito de álcool e risco 2,47 vezes maior de violência sexual entre gestantes. A distribuição geoespacial revelou concentrações de notificações em áreas periféricas do município, como a zona sul, leste e central. A modelagem preditiva indicou que a tendência de aumento persistirá nos próximos 24 meses, com estimativas de taxas alcançando até 12 casos por 100.000 habitantes. A aplicabilidade do Health Research Standard Process for Artificial Intelligence foi eficaz como modelo para análises de dados e desenvolvimento de algoritmos preditivos em saúde pública. Foi possível propor uma matriz metodológica replicável para futuras pesquisas e intervenções baseadas em evidências.
Is compassion more analogous to an infinite well in which individuals have unending reserves or a finite resource that wanes with use? To investigate this question, we created and tested a standardized acute paradigm in which participants repeatedly witnessed others' suffering. We longitudinally measured subjective, expressive, and physiological markers of compassion as participants watched 12 (Study 1 and preregistered Study 2) or 29 (preregistered Study 3) pilot-tested compassion-inducing videos. We repeatedly measured self-reports of compassion along with other measures, expressions of compassion, and physiological markers of compassion (e.g., respiratory sinus arrhythmia). Across three studies (Ntotal = 677), self-reports, expressions, and physiological markers of compassion showed no evidence of decline; instead, they remained stable or increased over time. We found evidence for changes in other psychological measures (e.g., greater reported difficulty coping) across the paradigm and documented declines in well-being along with the emergence of compassion fatigue symptoms from pre- to postparadigm. These findings suggest that the experience of compassion persists even in the face of repeated exposure to others' suffering, and that phenomena like compassion fatigue may reflect the burden of sustaining compassion rather than a decline in compassion. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
This qualitative study aimed to: (1) describe electrical injury (EI) survivors' and caregivers' experiences with navigating daily life after an EI and (2) explore EI survivors' and caregivers' experiences with social support during recovery. Semi-structured interviews were conducted. Interviews were audio recorded, transcribed and analyzed thematically. Qualitative descriptive design. Sixteen participants (12 survivors, 4 caregivers) who were treated at Sunnybrook Hospital or St. John's Rehab between 2000-2020 were recruited to participate in the study. Recovery trajectories were marked by uncertainty, with survivors and caregivers describing complex physical, neurological, neuropsychological, psychological, and social challenges. Across interviews, participants emphasized the burden of 'invisible' symptoms, including cognitive, emotional, and function-limiting difficulties that were often difficult for others to recognize or predict. Survivors emphasized the need for diverse support networks, while caregivers expressed emotional and informational needs. Peer and naturally occurring social supports proved critical, with engagement influenced by individual, social, and environmental factors. This study underscores the unique and multifaceted challenges faced by EI survivors and their caregivers, highlighting the critical importance of addressing both physical and psychosocial recovery. In clinical practice, these findings emphasize the need for a comprehensive, multidisciplinary approach that integrates medical management with psychological support and social services.
Afghanistan has experienced decades of war, political instability, displacement, poverty and structural upheaval, all of which are likely to have contributed to the population's deteriorating mental health. Individual studies and reports describe depression, anxiety, trauma-related distress and a severe lack of access to care, especially among women. However, the evidence remains fragmented. There has been no recent synthesis of evidence on mental health conditions, determinants, coping strategies, services and interventions among people living in Afghanistan. This protocol describes a systematic review of the literature on the mental health of this population. This systematic review protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) checklist. The review will be conducted and reported in accordance with PRISMA 2020. MEDLINE, Embase, APA PsycINFO, Web of Science and WHO Global Index Medicus will be searched using subject headings and keywords related to Afghanistan and mental health, with searches updated before final analysis. Relevant grey literature will also be included. Eligible study designs include quantitative, qualitative and mixed-methods studies reporting mental health outcomes, determinants, coping strategies, access to mental healthcare or mental health interventions among people living in Afghanistan. No language restrictions will be applied. Title and abstract screening and full-text review will be conducted independently by two reviewers, with disagreements resolved through discussion or, if necessary, adjudicated by a third reviewer. Data will be extracted using a piloted structured template. Given the expected heterogeneity in study designs and outcome measures, quantitative findings will be reported as frequencies and qualitative data will be analysed using thematic approaches to support the synthesis. Where appropriate, findings will be grouped by population subgroup and study setting. Study quality will be appraised using the Mixed Methods Appraisal Tool. Ethical approval is not required for this study as it will involve the analysis of previously published literature and publicly available reports. The findings will be disseminated through peer-reviewed publication and conference presentations and may inform clinicians, researchers, humanitarian agencies and policymakers. CRD420261403755.
Emergencies not only affect economic development and social stability but also pose serious challenges to the physical and mental health of the public. Depression is one of the most common chronic mental disorders following such events. However, few studies have explored the factors associated with depressive expression during emergencies. This research focuses on three core dimensions: cognitive appraisal, emotional response, and individual traits. It examines how perceived susceptibility, perceived severity, anxiety, sadness, self-focused attention and psychological resilience are associated with depressive expression levels. Unlike conventional approaches, this study employs a fine-tuned large language model (LLM) to detect depressive expression from social media data and aggregates the identified signals into hourly indicators for longitudinal regression analysis. Built on ChatGLM3 and manually annotated Weibo posts, the fine-tuned LLM has shown strong performance in Chinese social media depression recognition. The results show that these variables are significantly associated with depressive expression. Specifically, perceived susceptibility, perceived severity, anxiety, sadness, and self-focused attention function as risk factors, while psychological resilience serves as a protective factor. Our findings deepen the understanding of factors associated with depressive expression during crises and offer theoretical and empirical foundations for dynamic mental health monitoring and timely intervention.
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.
Traditional clinical assessments in psychiatric research or clinical practice rely on global retrospective self-report depression measures, which do not adequately capture intra- and interindividual variability in depressive symptoms over time and across contexts. This study aimed to (1) assess the sensitivity of mobile ecological momentary assessment (EMA) for monitoring depressive symptoms compared with traditional depression scales, (2) investigate changes in depressive symptoms and recall consistency observed between the first week (FW) and the second week (SW), and (3) identify subgroups at higher risk for depression and suicidal ideation, and characterize their sociodemographic, psychological, and psychiatric profiles. Participants' self-reports were collected once daily for 14 consecutive days via a mobile app-based EMA to monitor the presence of 20 depressive symptoms based on a 24-hour recall period, thereby capturing naturalistic severity and variability. Baseline questionnaires measured sociodemographic characteristics, digital sensitivity, and personality traits. On day 14, postquestionnaires were administered to assess their clinical symptoms. In addition, modified depression scales were administered on day 7 for 1-week recall, and day 14 for both 1-week and 2-week recalls. For cluster analysis, 3 active EMA-derived features were included: mean symptom severity, within-person symptom variability, and frequency of suicidal ideation. Generalized Linear Mixed Model analysis (model 1) revealed that traditional 2-week recall explained only 35.5% of the variance in daily symptom presence (odds ratio 0.666, 95% CI 0.659-0.674; P<.001). Additional Generalized Linear Mixed Model analysis (model 2) identified a robust interaction, indicating that the consistency between weekly retrospective recall and daily EMA differed significantly between FW and SW (F1, 81876=124.550; P<.001). While overall symptom severity scores significantly decreased from FW to SW across both assessment methods (Cohen d=0.10-0.34; P<.001), the estimated mean of the probability of symptom reporting showed a contrasting upward trend from 0.853 to 0.908. In cluster analysis, 695 participants (244 males and 451 females; aged 19-73 years, mean 36.14, SD 10.71 years) who completed at least 7 EMA sessions over a 2-week period were classified into three distinct clusters: (1) no or low risk (n=445, 64.0%), (2) moderate risk (n=223, 32.1%), and (3) high risk (n=27, 3.9%). While depressive symptom severity, frequency of suicidal ideation, and psychiatric profiles progressively increased across clusters (cluster 1<2<3), the highest symptom variability was observed in cluster 2 (cluster 1<3<2). This study demonstrated that mobile EMA effectively reduced recall bias in assessing depressive symptoms and revealed symptom dynamics. Using a minimal set of active EMA-derived features, we differentiated 3 distinct risk clusters; within-person symptom variability emerged as a clinically significant indicator not captured by traditional 2-week recall-based assessments. Despite the brief 2-week assessment period, these findings suggest that mobile EMA may serve as a robust real-world data collection tool.
Estrogen decline during menopause transition is associated with physical and psychological symptoms that impair overall well-being. In a previous randomized trial, a probiotic formula comprising Levilactobacillus brevis KABP052, Lactiplantibacillus plantarum KABP051, and Pediococcus acidilactici KABP021 was found to be associated with a slower decline in estrogen levels. Therefore, we hypothesized that the intake of 1×109 colony-forming units/day of this formula could improve menopausal symptoms and quality of life. We conducted a decentralized, randomized, double-blind, placebo-controlled trial using a real-world approach. Women between 45 and 60 years old who were in perimenopause or postmenopause and had Cervantes Quality of Life score ≥ 38 were enrolled and allocated 2:1 to the probiotic (n=160) or placebo group (n=85) for a 3-month period. Menopausal symptoms and quality of life were evaluated by using the Menopause Rating Scale II, Cervantes and Utian Quality of Life questionnaires. In the full analysis set, Menopause Rating Scale II total score decreased significantly in the probiotic group compared to placebo across the study (global mean difference between groups: -1.00 [0.47], P=0.033), with an improvement in the somato-vegetative domain (-0.54 [0.20], P=0.007). Per-protocol analysis also revealed differences in the psychological domain between groups, favoring the probiotic (-0.51 [0.25], P=0.040). Cervantes scale showed no significant differences between groups, but the change in Utian Quality of Life score was significantly higher in the probiotic group (2.21 [1.07], P=0.040). In this real-world study, the probiotic formula was associated with improvements in menopause-associated symptoms and quality of life, whereas the global Cervantes score appeared to be similar between groups. Future investigations are required to confirm this clinical effect and the underlying mechanisms of action. ClinicalTrials.gov identifier: NCT06604234.