Maladaptive Daydreaming (MD) is an underrecognized phenomenon characterized by immersive, compulsive fantasies that cause distress and impairment. Not yet formally recognized, MD often goes unnoticed in clinical settings. This case explores the experience, assessment, and management of MD in an adolescent girl. A 15-year-old girl presented with 1.5 years of excessive daydreaming, leading to declining academics, social withdrawal, and emotional distress. She had no psychiatric history. Assessment involved the Structured Clinical Interview for Maladaptive Daydreaming (SCIMD), MDS-16, questionnaires on daydream content, Hamilton Rating Scales for Anxiety and Depression, and the Young Schema Questionnaire. In-depth interviews were analyzed thematically. Assessment revealed her MD was an escape from discomfort, fulfilling unmet needs for love, acceptance, and control. Themes included romantic relationships, an idealized self, and wish fulfillment, linked to early maladaptive schemas like disconnection & rejection, over vigilance & inhibition, other-directedness, and impaired limits. A six-month Schema Therapy plan was developed to address emotional triggers, build healthier coping, and reduce reliance on MD. This case highlights MD as a coping strategy for unmet emotional needs, particularly in adolescence. Schema Therapy effectively addressed root causes beyond symptom control. The case underscores the importance of recognizing MD as a legitimate clinical concern. MD significantly impacts young lives but is often hidden. This case supports the need for increased clinical awareness and structured assessment/treatment approaches. Schema Therapy shows promise in managing the deeper emotional issues driving MD.

BackgroundSaliva-derived small extracellular vesicles (sEVs) are emerging as potential biomarkers for coronary artery disease (CAD). Early identification of these biomarkers is essential for effective management and improved patient outcomes. Our study aimed to isolate and characterize sEVs from saliva to identify non-invasive protein signatures in younger CAD patients.MethodsSaliva sEVs were obtained from 20 CAD patients aged 18–65 years, and 20 healthy controls matched for age and gender. The saliva exosome or sEVs isolation was performed using differential ultracentrifugation and sucrose density gradient methods, and we characterized the sEVs using transmission electron microscopy, scanning electron microscopy, and nanoparticle tracking analysis. Western blotting was done with exosome markers including Anti-Flotilin-1, Anti-TSG-101, and Anti-CD63. Differentially expressed proteins (DEPs) were identified through label-free LC–MS/MS Orbitrap and data was analyzed using Proteome Discoverer 3.0 and statistical analysis using MetaboAnalyst 6.0. Protein–protein interaction network, gene ontology, and pathways enrichment analysis were performed.ResultsWe identified 506 proteins using label-free LC–MS/MS proteomic approaches, with 18 significant DEPs. Notable upregulated proteins included mainly Cystatin-S (CST1/CST2/CST4), Protein S100, alpha-amylase, and Gelsolin (GSN), while downregulated proteins included Serum albumin (ALB) and Apolipoprotein A1 (APOA1). These proteins are linked to inflammation and salivary secretions largely.ConclusionsFor the first time, we present unique saliva sEVs protein signatures associated with CAD. Validation in larger cohorts may establish Cystatin S as a potential diagnostic biomarker for CAD.Graphical Supplementary InformationThe online version contains supplementary material available at 10.1186/s12014-025-09541-9.

The pervasive presence of smartphones and social media platforms has raised growing concerns about adolescents’ compulsive and seemingly mindless usage. This viewpoint explores the psychological implications of compulsive scrolling behavior, particularly via features such as auto-play and infinite scroll on platforms such as Instagram Reels. The term “mindless usage” is operationally defined as repetitive, automatic engagement with digital content without conscious reflection or goal-oriented intent, often shaped by persuasive platform design. This article further contextualizes how adolescents are often “lost” in digital interactions, not physically, but emotionally and cognitively, as they navigate overwhelming streams of algorithmically tailored content. While digital tools offer connection and creative expression, this article highlights their darker implications and proposes actionable steps for stakeholders to mitigate risks. Integrating recent findings, it offers a framework for promoting healthier digital habits among vulnerable youth populations.

Parkinson's disease (PD) affects approximately 2% of individuals over the age of 60. With over two billion Muslims observing Ramadan, individuals with PD encounter specific challenges, such as deteriorating motor skills, sleep disturbances, and an increased risk of falls during fasting. Our study focused on 75 patients with idiopathic PD divided into two groups: the Ramadan Regimen group, consisting of 50 patients who adjusted their medication to twice daily at Suhoor and Iftar, and the Non-Treatment group, which included 25 patients who abstained from medication for religious reasons. Both groups were instructed to wear a Parkinson's Kinetigraph (PKG) wrist device. Study findings showed that motor function worsened in the non-treatment group (p < .001), while it improved in the Ramadan Regimen group (p = .007). Daytime sleepiness also significantly increased in the non-treatment group (p < .001). Overall, findings suggest that Ramadan regime significantly enhance patient health and quality of life.

ABSTRACT Homelessness is a multifaceted issue that extends beyond the lack of basic needs, intertwining with various psycho-social factors, such as mental health, family dynamics, social isolation, and personal struggles. These factors contribute to the vulnerability of homeless individuals, while significant barriers to accessing support services exacerbate their situation. The present study aimed to develop and validate a questionnaire to assess psycho-social determinants of homelessness and identify barriers to support services. The process involved three stages: Questionnaire Preparation (63 items were developed based on literature and expert consultations), Content Validation (10 experts evaluated the items for relevance using a 4-point Likert scale, and the Content Validity Index (CVI) was calculated to refine the tool) and lastly, Cognitive Interviews were done on 15 homeless individuals for testing the comprehensibility of the questionnaire, and revisions were made to improve clarity. The final questionnaire contained 56 items distributed across 4 sections after validation, reflecting key psycho-social factors influencing homelessness. The validated tool offers valuable insights into the psycho-social factors influencing homelessness and can inform research and policy aimed at improving the well-being of homeless individuals.

BackgroundRehabilitation is an essential health service that should be available for all with health conditions affecting functioning in daily life. Initiatives for equitable distribution of scarce and limited rehabilitation resources are frequently guided by burden of diseases measures. Most studies on burden of diseases have laid greater emphasis on disability adjusted life years (DALYs) and rarely compared these burdens among conditions. This present study aims to systematically review and compare the burden of the top 10 GBD ranking of disorders.MethodThis review was pre-registered with PROSPERO (CRD42022316091). PubMed and Google Scholar were systematically searched as well as a manual search of grey literatures from 01/01/1990 to 29/02/2022. The results of this review were reported based on PRISMA guideline. Meta-analysis results were presented using forest plots and summary tables.ResultsA total of 11,367 studies were obtained from the searches, while the findings of 55 studies (17,753,434 participants) were reviewed. Majority of the studies were conducted in high-income-countries (56.1%) though, all the studies on neonatal disorders (100.0%) and congenital birth disorders (100.0%) came from the low-and-middle-income-countries. Neonatal disorders, stroke and ischaemic heart disease (IHD) topped the rank of disease burden. Overall, the burden of neurological disorders and their associated risk factors (aRFs), in terms of disease prevalence, were evaluated to be 36.75% while their mortality rate was 29.90%. Neurological conditions and aRFs accounted for 61.83% of total economic burden.ConclusionNeonatal disorders, stroke and IHD are the three most burdensome disorders. There is therefore need for greater focus of rehabilitation attention and resources in the coming decades.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12967-024-05987-x.

ABSTRACT Homelessness and severe mental illness (SMI) feed into each other, generating cycles of exclusion, relapse, and systemic neglect. In low- and middle-income countries like India, underfunded services, stigma, and disorganized housing policies heighten these vulnerabilities, and this is a matter of public health urgency. This series of cases investigates the psychosocial determinants of homelessness among people with SMI in Delhi and the contribution of psychiatric social work interventions to recovery and reintegration. Four purposively sampled homeless persons with mental illness who were admitted to a tertiary psychiatric hospital were observed. Data were collected using in-depth interviews, case file review, psychosocial evaluation, and collateral feedback from families, shelter workers, and police. Thematic analysis was used to determine determinants, barriers, and pathways of recovery. The study followed CARE guidelines to ensure completeness and transparency. It examined four cases: a foreign national with persecutory delusions, a traumatized man with polysubstance dependence, a young adult with suicidality and psychosis, and an untreated professional with psychosis. Psychiatric social work interventions included counseling, psychoeducation, trauma-informed care, vocational referrals, and multi-sectoral coordination. Outcomes ranged from reintegration and NGO-supported rehabilitation to chronic instability and bleak prognosis. Findings highlight trauma, stigma, gendered risks and systemic neglect in homelessness among SMI.