Previous literature has highlighted the importance of psychosocial factors such as the perception of an adequate social support network or the subjective experience of life satisfaction in promoting well-being in older adults and facilitating healthy aging processes. The objective of the present study was to analyze the possible relationship between the level of resilience and social support in healthy older adults, and how these variables may influence experiences of life satisfaction. Furthermore, potential moderation relationships between these variables were analyzed. The sample consisted of 42 healthy older adults (71.4% women), with a mean age of 66.57 years (standard deviation (SD) = 5.82). Participants completed a battery of questionnaires that included a sociodemographic questionnaire, the Connor-Davidson Resilience Scale (CDRISC), the Duke-UNC Functional Social Support Questionnaire (Duke-UNC-11), and the Satisfaction With Life Scale (SWLS). The results of the multiple regression analyses indicate that resilience and social support positively and significantly predict life satisfaction. Furthermore, moderation analyses indicate that social support moderates the relationship between resilience and life satisfaction, jointly explaining 44.98% of the variance of this indicator of wellbeing. Specifically, the positive association between resilience and life satisfaction was stronger at lower levels of perceived social support. These findings suggest that resilience may play a particularly relevant role in life satisfaction when perceived social support is limited. However, the small sample size, the predominance of women, and the selective recruitment of healthy older adults warrant caution when generalizing the results. Overall, the findings support the need to expand the study of the correlations of well-being in old age, as well as to develop intervention programs aimed at promoting optimal aging that include strategies to improve resilience and foster functional social support networks.

To explore the association between an optimised emergency procedure combined with structured health education and anxiety, depression and treatment outcomes in patients with acute ischaemic stroke (AIS). We conducted a retrospective cohort study of 114 AIS patients admitted to our stroke centre between January and December 2023. On the basis of the admission timeframe, patients were divided into a conventional care group (n = 57, January to June 2023, routine care) and a comprehensive nursing group (n = 57, July to December 2023, optimised integrated care). Emergency nursing outcomes were assessed after stabilisation and before ward transfer. Neurological recovery was assessed with the European Stroke Scale (ESS); anxiety and depression were assessed with the Generalized Anxiety Disorder-7 (GAD7) and Patient Health Questionnaire-9 (PHQ-9) as primary psychological indicators. Process times and nursing satisfaction were also evaluated. Data analysis was conducted using SPSS 27.0. Normality was verified using the Shapiro-Wilk test. Normally distributed data were expressed as mean ± standard deviation and analysed using an independent samples t-test, whereas non-normal data were expressed as median (interquartile range) and analysed using the Mann-Whitney U test. Categorical data were analysed using chi-square test. Multivariate linear and logistic regression were used to analyse indicators such as neurological function and nursing satisfaction, adjusting for confounding factors. A p-value < 0.05 was considered statistically significant. Compared with the conventional care group, the waiting time, diagnosis time, emergency room waiting time and recanalisation time of patients in the comprehensive nursing group were significantly shortened (p < 0.05). The degree of improvement in ESS (∆ESS) in the comprehensive nursing group was significantly higher, and the reductions in GAD-7 and PHQ-9 scores were also significantly greater (p < 0.05). Patient and family satisfaction in the comprehensive nursing group were significantly higher than those in the conventional care group (p < 0.05). Through multivariate linear regression analysis, with baseline National Institutes of Health Stroke Scale (NIHSS) score, time from onset to visit, hypertension and diabetes as adjustment factors, allocation to the comprehensive nursing group was still significantly correlated with ∆ESS (β [95% confidence interval (CI)] = 8.15 [5.72 to 10.58], p < 0.001), ∆GAD-7 (β [95% CI] = -2.18 [-2.92 to -1.44], p < 0.001), and ∆PHQ-9 (β [95% CI] = -2.65 [-3.32 to -1.98], p < 0.001). The results of multivariate logistic regression analysis showed that, after adjusting for the above confounding factors, inclusion in the comprehensive nursing group was independently associated with a significantly higher likelihood of obtaining a satisfactory nursing evaluation (adjusted OR = 8.915, 95% CI: 2.453 to 32.468, p = 0.001). The integrated model is associated with shorter treatment times, better neurological recovery, reduced anxiety and depression and higher satisfaction in AIS patients, providing preliminary evidence for a patientcentred comprehensive emergency care model.

Cognitive impairment is a common complication in patients with chronic obstructive pulmonary disease (COPD) that substantially affects their treatment adherence, self-management ability and prognosis; it is an important extrapulmonary complication. Its pathogenesis is complex and mainly involves cerebral hypoperfusion and neuronal damage caused by chronic hypoxemia and disruption of the blood-brain barrier and neural structures by systemic inflammatory responses. Smoking, frequent acute exacerbations, coexisting cerebrovascular diseases, anxiety, depression and sleep disorders are amongst the multiple factors that contribute to and accelerate cognitive decline. This article aims to review the pathogenesis, related factors and intervention measures of cognitive impairment in patients with COPD to provide a reference for improving cognitive function in such patients.

Schizophrenia is a severe mental disorder associated with significantly higher mortality risk than the general population, constituting a major public health challenge. Clarifying temporal trends in mortality among patients with schizophrenia helps inform targeted clinical and public health interventions. To assess changes in mortality rates over the last 2 years in patients with schizophrenia from one district of Shanghai, China. This longitudinal cohort study assessed the mortality of individuals with schizophrenia (n = 5234) from April 1, 2021, to March 31, 2023. The early cohort (up to March 31, 2022) contained 5207 individuals and the late cohort (up to March 31, 2023) contained 5114 individuals. Partitions of Pearson's chi-square statistic were used to conduct pairwise comparisons. A multivariable Cox proportional hazards model was used to assess the effects of different factors on mortality risk. Data were drawn from the official Shanghai database used for following-up individuals with severe mental health disorders. The total number of deaths was 370. Of these, 120 occurred in the early cohort (2.30% of the cohort) and 250 in the late cohort (4.89% of the cohort). Individuals with schizophrenia in the late cohort had a 5.08- fold increased mortality risk than individuals in the general population. In the early cohort, mortality rates remained relatively stable (0.29%-0.48%). There were peaks in mortality rates (2.23%) in December 2022 and January 2023. Men had a higher risk of mortality than women (hazard ratio [HR], 1.294; 95% confidence interval [CI], 1.035-1.618; p = 0.024). Age was a contributing factor to the mortality of people with schizophrenia (HR, 1.048; 95% CI, 1.040- 1.056; p < 0.001). Being unmarried (HR, 1.956; 95% CI, 1.522-2.513; p < 0.001), divorced (HR, 1.481; 95% CI, 1.010-2.170; p = 0.044), or widowed (HR, 1.334; 95% CI, 0.958-1.856; p = 0.088) was associated with a high risk of mortality. Age of onset (HR, 1.046; 95% CI, 1.037- 1.054; p < 0.001) and illness duration (HR, 1.044; 95% CI, 1.037-1.051; p < 0.001) were associated with high mortality risk. The late cohort showed a higher mortality rate than the early cohort (HR, 2.427; 95% CI, 1.467-4.014; p = 0.001). The mortality of patients with schizophrenia was not significantly related to education level, economic status, or symptom onset. These findings highlight trends in schizophrenia mortality since April 2021. Compared with the general population, individuals with schizophrenia had higher mortality risk, particularly adults aged ≥65 years and women with low education.

No abstract present.

This study aimed to investigate the causal relationship between serum 25-hydroxyvitamin D (25(OH)D) levels and the risk of depression and anxiety, using Mendelian Randomization (MR) analysis from a genetic variation perspective. Genome-wide association study (GWAS) summary statistics for 25(OH)D levels, depression and anxiety were retrieved from the IEU Open GWAS Project, specifically from datasets "ebi-a-GCST90000617", "ebia-GCST90013878", and "ukb-a-82". A two-sample MR analysis was conducted with 25(OH)D levels as the exposure and depression and anxiety as outcome variables. Cochran's Q test was used to assess heterogeneity among the instrumental variables, and horizontal pleiotropy was tested using the MR-Egger intercept method. Sensitivity analyses were conducted via the leave-one-out approach. The MR analysis, utilizing 32 single nucleotide polymorphisms (SNPs) as instrumental variables, revealed a significant causal association between 25(OH)D levels and depression, with all MR methods (excluding Simple Mode) yielding p-values < 0.05. The odds ratios (ORs) and 95% confidence intervals (CIs) for the significant methods were: OR = 0.82 [95% CI: 0.68-0.98], OR = 0.85 [95% CI: 0.77-0.95], OR = 0.80 [95% CI: 0.68-0.93] and OR = 0.90 [95% CI: 0.82-0.98]. However, no significant causal relationship was found between 25(OH)D levels and anxiety. In the reverse direction, genetically predicted depression showed a potential causal association with lower 25(OH)D levels (inverse variance weighting (IVW) OR = 0.98, 95% CI: 0.96-1.00, p = 0.02), while no such association was observed for anxiety. This study suggests that higher serum 25(OH)D levels may be associated with a lower risk of depression, highlighting the potential of serum 25(OH)D as an early biomarker for depression prevention and clinical management. However, no causal association was found between 25(OH)D levels and anxiety, warranting further investigation. This study provides a potential vitamin D-related intervention direction for the prevention and clinical management of depression.

This study aimed to investigate the differential effects of accelerated high-frequency repetitive transcranial magnetic stimulation (aHF-rTMS) administered in the morning and afternoon on sleep outcomes in hospitalised patients with schizophrenia. This single-centre retrospective cohort study was based on existing inpatient records from the Department of Psychiatry at The Third People's Hospital of Fuyang between November 2023 and May 2025. Eligible cases were identified from electronic medical records, nursing documentation and aHF-rTMS treatment logs. Patients were divided into a morning aHF-rTMS group and an afternoon aHF-rTMS group according to the predominant treatment-time category documented during hospitalisation. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and nighttime sleep duration was obtained from nursing records. Psychiatric symptoms and cognitive function were assessed using the Positive and Negative Syndrome Scale (PANSS) and Montreal Cognitive Assessment (MoCA), respectively. The influencing factors of sleep outcomes at discharge were explored by multivariate linear regression analysis, and sensitivity analysis was performed using propensity score matching. The two groups were comparable in baseline demographics, sleep parameters and psychiatric symptoms. During hospitalisation, both groups showed substantial improvement in sleep quality and psychiatric symptoms compared with those upon admission. The morning aHF-rTMS group had significantly lower total PSQI scores at discharge (p < 0.001) and longer nighttime sleep duration (β = 0.58, p < 0.001) than the afternoon aHF-rTMS group. Sensitivity analysis showed that morning aHF-rTMS remained associated with low total PSQI scores at discharge (β = -1.83, p < 0.001). No statistically significant differences in PANSS total scores and MoCA scores at discharge were found between the two groups (both p > 0.05). The overall incidence of adverse reactions was 44.44%, slightly higher in the morning group than in the afternoon group (54.02% vs. 35.48%, p = 0.012). The timing of aHF-rTMS treatment may be associated with sleep-related treatment outcomes in hospitalised patients with schizophrenia. Compared with afternoon treatment, morning aHF-rTMS was associated with better subjective sleep quality and longer nighttime sleep duration.

This study aimed to explore how Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment (PERMA)-based nursing anxiety, depression, post-traumatic stress symptoms (PTSD) and quality of life in patients with post-burn scar plastic surgery. A retrospective cohort study was conducted using data from patients who underwent scar plastic surgery for burn-related scar at our hospital between January 2023 and January 2025. Based on the type of nursing care they received, we divided patients into two groups: 51 patients who received PERMA-based nursing were assigned to the PERMA nursing group, and 51 patients who received routine nursing only were assigned to the routine nursing group. Both groups received 12 weeks of nursing care. We assessed all outcome measures, including the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), PTSD Checklist-Civilian Version (PCLC), Simplified Coping Style Questionnaire (SCSQ), SelfAcceptance Questionnaire (SAQ), and Generic Quality of Life Inventory-74 (GQOL-74), were assessed at baseline and again after the 12-week nursing period in both groups. Pearson correlation analysis was performed to evaluate the relationships among the psychological improvement scores. After the nursing intervention, both groups showed decreases in SAS scores, SDS scores, PCL-C scores, and negative coping scores of both groups decreased after the nursing, and those of the PERMA nursing group were lower (p < 0.05). The positive coping scores and SAQ scores of both groups increased, and those of the PERMA nursing group were higher (p < 0.05). The GQOL-74 scores of both groups increased after the nursing, and those of the PERMA nursing group were higher (p < 0.05). Correlation analysis revealed that anxiety relief (∆SAS) was significantly tied to improvements in both depression and PTSD symptoms. Furthermore, reductions in negative coping strategies (∆negative coping) acted as a key factor that correlated with lower levels of anxiety and traumatic stress. PERMA-based nursing is associated with reduced anxiety, depression, and PTSD symptoms, as well as improved coping strategies, self-acceptance, and improved quality of life in patients undergoing scar plastic surgery after burn.

Suicidal ideation and non-suicidal selfinjury (NSSI) are highly prevalent during early adolescence and represent serious public health concerns. Emotional dysregulation has been identified as a transdiagnostic factor underlying various risk behaviors, particularly in youth with externalizing difficulties such as attentiondeficit/hyperactivity disorder (ADHD). While prior research has examined these factors independently, few studies have explored their joint and differential contribution to suicide-related outcomes in early adolescence. This study aimed to examine the association of ADHD-related symptoms, positive and negative affect, and emotional dysregulation with suicidal ideation and NSSI, as well as to explore whether emotional dysregulation moderates the relationship between ADHD-related symptoms and these risk behaviors. A total of 1079 Spanish adolescents (Mage = 12.6 years, SD = 0.6) enrolled in the first year of compulsory secondary education participated in a cross-sectional study. Standardized self-report measures were used to assess ADHD-related symptoms (Strengths and Difficulties Questionnaire [SDQ]), affect (Positive and Negative Affect Schedule for Children and Adolescents [PANAS-N]), and difficulties in emotion regulation (Difficulties in Emotion Regulation Scale [DERS-18]), alongside indicators of suicidal ideation and NSSI. Data analysis included group comparisons and hierarchical logistic regression models. Suicidal ideation was reported by 10.1% of participants, and NSSI by 16.4%. Adolescents with either behavior exhibited significantly more hyperactivityinattention symptoms, greater negative affect, lower positive affect, and substantially elevated emotional dysregulation. In regression analyses, ADHD-related symptoms remained significant predictors after accounting for affect, although emotional dysregulation emerged as the strongest predictor, reducing the effects of other variables. Specific dimensions such as lack of emotional clarity and nonacceptance of emotional responses were associated with suicidal ideation, while impulse control difficulties and lack of adaptive strategies predicted NSSI. No moderation effects were found. ADHD-related symptoms and emotional dysregulation both contribute independently to adolescent suicidal ideation and NSSI, with emotional dysregulation showing the most robust predictive value. Schoolbased prevention efforts should incorporate emotion regulation skill-building to reduce suicide risk and NSSI in early adolescence.

Psychotic spectrum disorders are associated with persistent impairments in psychosocial functioning that are not fully explained by symptom severity, particularly in individuals with chronic courses and prolonged hospitalization. Beyond psychopathological symptoms, relatively stable cognitive-emotional styles may influence long-term adaptation, subjective recovery, and quality of life in severe mental disorders. To examine the psychometric properties of the MOLDES questionnaire in a clinical sample of patients with psychotic spectrum disorders receiving long-term psychiatric care. A cross-sectional observational study was conducted in a sample of 83 clinically stable male patients with psychotic spectrum disorders hospitalized in a long-term psychiatric care unit. Internal consistency of the global MOLDES score and its three dimensions (Vital Spontaneity, Adjustment, and Optimization) was assessed using Cronbach's alpha. Convergent and discriminant validity were explored through Spearman's correlations with psychotic symptom severity, depressive symptoms, internalized stigma, and quality of life. The global MOLDES score and its dimensions showed acceptable internal consistency, with Cronbach's alpha values ranging from 0.70 to 0.77. No significant associations were observed between MOLDES dimensions and psychotic or depressive symptom severity, supporting discriminant validity. In contrast, Vital Spontaneity and Adjustment were negatively correlated with internalized stigma, while the Optimization dimension showed a positive association with quality of life. These findings provide preliminary evidence supporting the reliability and validity of the MOLDES questionnaire in patients with chronic psychotic disorders. The instrument appears to capture adaptive cognitive-emotional styles that are largely independent of symptom severity and meaningfully related to relevant psychosocial outcomes, suggesting its potential usefulness as a complementary assessment tool in long-term psychiatric care and rehabilitation-oriented settings.